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Conclusionsĭespite varying opioid administration characteristics between Asia, Europe, and the United States, opioid-induced respiratory depression remains a common global problem on general care medical and surgical wards. Multivariable analysis identified post-procedure tramadol (OR 0.62, 95% CI 0.424–0.905, p = 0.0133) and post-procedure epidural opioids (OR 0.485, 95% CI 0.322–0.731, p = 0.0005) being associated with a significant reduction in opioid-induced respiratory depression. Considering only postoperative opioids, 54% ( N = 119/220) and 45% ( N = 347/779) of patients receiving only short-acting opioids or only long-acting opioids experienced ≥1 episode of opioid-induced respiratory depression, respectively. The type and median total morphine milligram equivalent (MME) of opioid administered varied significantly by region, with 31.5 (12.5–76.7) MME, 31.0 (6.2–99.0) MME, and 7.2 (1.7–18.7) MME in the United States, Europe, and Asia, respectively ( p < 0.001). ResultsĪcross all patients, 58% received only long-acting opioids, 16% received only short-acting (<3 h) opioids, and 21% received a combination of short- and long-acting (≥3 h) opioids. Opioid-induced respiratory depression, defined as respiratory rate ≤ 5 bpm, SpO 2 ≤ 85%, or ETCO 2 ≤ 15 or ≥ 60 mmHg for ≥3 min apnea episode lasting >30 s or any respiratory opioid-related adverse event. Interventionsīlinded, alarm-silenced continuous capnography and pulse oximetry monitoring.
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Patientsġ335 patients receiving parenteral opioids. Designġ6 general care medical and surgical wards in Asia, Europe, and the United States. The objective of this analysis was to evaluate the geographic differences of opioid administration and examine the association between opioid administration characteristics and the occurrence of respiratory depression.
#Prodigy anesthesia trial#
The PRODIGY trial found that among ward patients receiving parenteral opioids, 46% experienced ≥1 respiratory depression episode. Opioid administration for pain in general care floor patients remains common, and can lead to adverse outcomes, including respiratory compromise. Here are the usernames and passwords for all the Prodigy Anesthesia has. Overdyk, Fabio Di Piazza, Leif Saager Study objective Bergese, Wolfgang Buhre, Maria Wittmann, Morgan Le Guen, Frank J. Postoperative opioid administration characteristics associated with opioid-induced respiratory depression: Results from the PRODIGY trial Journal of Clinical Anesthesia ( IF 9.452), Pub Date : , DOI: 10.1016/j.jclinane.2021.110167 Richard D.