Avoid Opioid-Related Respiratory Depression
Continuous electronic monitoring tops pulse oximetry or spot checks.
A
t certain
dosages, the
opioids you
give to patients to
manage surgical pain
can lead to respiratory
depression— and
overdoses can lead to
respiratory failure.
Intermittent spot
checks of oxygenation
(pulse oximetry) and
ventilation (nursing
assessment) are not
adequate for reliably
recognizing drug-
induced respiratory
depression in the post-
operative period.
Rather, you should
consider continuous
electronic monitoring
with both pulse
oximetry for oxygenation and capnography for the adequacy of venti-
lation for patients undergoing moderate and conscious sedation, as
well as for those managing pain using a patient-controlled analgesia
(PCA) pump.
• Pulse oximetry. Pulse oximetry is a lagging indicator of respirato-
3 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 7
Safety
Michael Wong, JD
• KNOW SOONER Studies have shown that monitoring of end-tidal CO
2
provides an
earlier indication of respiratory distress than intermittent checks or pulse oximetry.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
