Respiratory monitoring after administration of neuraxial morphine for cesarean delivery analgesia*

Patients should receive multimodal analgesia (eg, NSAIDs, acetaminophen) in addition to neuraxial morphine.

BMI: body mass index; OSA: obstructive sleep apnea; PACU: post-anesthesia care unit; ASA: American Society of Anesthesiologists; RR: respiratory rate; ASRA: American Society of Regional Anesthesia and Pain Medicine; NSIADs: nonsteroidal anti-inflammatory drugs.

* All patients should receive routine postcesarean delivery vital sign monitoring in addition to the respiratory monitoring that appears in this algorithm.
¶ Based on ASA/ASRA practice guidelines for the general patient population^[1].

Adapted from: Bauchat JR, Weiniger CF, Sultan P, et al. Society for Obstetric Anesthesia and Perinatology Consensus Statement: Monitoring Recommendations for Prevention and Detection of Respiratory Depression Associated With Administration of Neuraxial Morphine for Cesarean Delivery Analgesia. Anesth Analg 2019; 129:458. DOI: 10.1213/ANE.0000000000004195. Copyright © 2019 International Anesthesia Research Society. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.
Reference:

Practice Guidelines for the Prevention, Detection, and Management of Respiratory Depression Associated with Neuraxial Opioid Administration: An Updated Report by the American Society of Anesthesiologists Task Force on Neuraxial Opioids and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology 2016; 124:535.

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Respiratory monitoring after administration of neuraxial morphine for cesarean delivery analgesia*