ASA guidelines for monitoring …are they reasonable?

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)

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