Quantifying the incidence of clinically significant respiratory depression in women with and without obesity class III receiving neuraxial morphine for post-cesarean analgesia: a retrospective cohort study

•Incidence of respiratory depression post-cesarean after neuraxial morphine.•Guidelines recommend increased monitoring of obesity class III patients.•Incidence of respiratory depression in non-obese 9.4/10 000 (95% CI 3.7 to 24.3).•Incidence in obesity class III 25.7/10 000 (95% CI 11.0 to 60.0).•St...

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Bibliographic Details
Published in:International journal of obstetric anesthesia 2021-08, Vol.47, p.103187-103187, Article 103187
Main Authors: Ende, H.B., Dwan, R.L., Freundlich, R.E., Dumas, S., Sorabella, L.L., Raymond, B.L., Lozada, M.J., Shotwell, M.S., Wanderer, J.P., Bauchat, J.R.
Format: Article
Language:English
Subjects:
Cesarean delivery
Neuraxial morphine
Obesity
Respiratory depression
Respiratory monitoring
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Summary:•Incidence of respiratory depression post-cesarean after neuraxial morphine.•Guidelines recommend increased monitoring of obesity class III patients.•Incidence of respiratory depression in non-obese 9.4/10 000 (95% CI 3.7 to 24.3).•Incidence in obesity class III 25.7/10 000 (95% CI 11.0 to 60.0).•Study was underpowered to identify a risk difference (OR 2.2, 95% CI 0.6 to 6.9). Obesity is a suspected risk factor for respiratory depression following neuraxial morphine for post-cesarean analgesia, however monitoring guidelines for obese obstetric patients are based on small, limited studies. We tested the hypothesis that clinically significant respiratory depression following neuraxial morphine occurs more commonly in women with body mass index (BMI) ≥40 kg/m2 compared with BMI
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2021.103187