http://wiki.med.uottawa.ca/display/WIKITHESIA/ASA+Guidelines.+Neuraxial+Opioids
Main fear of any anesthesiologist working in OB is (besides aspiration on c-section with GA)—respiratory depression after intrathecal or epidural morphine.Red flag goes up in anesthesiologist brain when somebody says “SPINAL MORPHINE”. Scariest thing is that respiratory depression is delayed (8-12h) , sneaky thing. And ASA guidelines are —monitor every 1 hour(in busy place its enormous burden for nurses).Outcome of all that —intrathecal or epidural morphine(unquestionably the best pain relief after c-section) is used maybe only in 40% hospitals in US.
We desided to reflect on fears and analyse ASA guidelines.
Facts —-respiratory depression in OB is very rare, up to 2010 in 14.000.000 cases —no death from respiratory depression in OB after intrathecal morphine. It happens , but very rare.
(to be followed)