Opioid Safety, Respiratory Compromise

Hypoxemia in the PACU: Most Episodes Occur After 30 Minutes from Admission

By Sean Power, Community Manager, Physician-Patient Alliance for Health & Safety

Is reliance on pulse oximetry to detect hypoxemia related to opioid-induced respiratory depression the best practice to identify patients at risk?

Toby N Weingarten, MD, Associate Professor of Anesthesiology, Mayo Clinic, Rochester, MN, raises this question by calling attention to an analysis by Epstein et. al.,[1] which found that, contrary to expectations, most episodes of hypoxemia—abnormally low concentrations of oxygen in the blood—take place after 30 minutes from admission to the postanesthesia care unit (PACU). He notes that the administration of opioids was greater in patients who experienced hypoxemia than those who did not.

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