• G T Palleschi, M Gerasimov, M J Blitz, J L Aronsohn, L Shore-Lesserson, A Ruggiero, G Lim, and A S Habib.
• Department of Anesthesiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA. Electronic address: gpalleschi@northwell.edu.
• Int J Obstet Anesth. 2022 Nov 1; 52: 103592103592.

BackgroundNeuraxial administration of long-acting opioid is the "gold standard" for the management of postoperative pain following cesarean delivery. Respiratory depression, however, remains a concerning complication.MethodsThis retrospective single-center study of 4963 patients evaluated the frequency of respiratory depression after neuraxial morphine administration in a post-cesarean delivery population. The spinal dose of morphine varied from 100 to 450 µg intrathecally, and from 3 to 5 mg epidurally. The primary outcome was the initiation of a Rapid Response Team (RRT) event for respiratory failure due to neuraxial opioid in the 24 h following morphine administration. Secondary outcomes studied included oxygen desaturation events (SpO2 <90%), initiation of oxygen therapy and naloxone administration.ResultsThere were no respiratory RRT events within the study period (95% confidence interval [CI] 0 to 7 per 10 000). There were no desaturation events recorded and no patients received supplemental oxygen therapy or naloxone (95% CI 0 to 7 per 10 000).ConclusionClinically significant respiratory depression is rare among patients receiving neuraxial morphine for post-cesarean delivery analgesia.Copyright © 2022 Elsevier Ltd. All rights reserved.

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