Table 4.
Incidence of Respiratory Depression with Epidural Analgesia – Pediatric Data
| Study, Year, Ref #(n) | Study Design | Opioid | Incidence of Respiratory Depression | Criteria |
|---|---|---|---|---|
| Krane, 1989(26) (32) | RCT | morphine | 3.1% | Not specified |
| Kart, 1997a(31) | RCT | fentanyl morphine | 0% | Not specified |
| Goodarzi, 1999 (23) (90) | RCT | morphine fentanyl hydro-morphone | morphine: 25%(none severe) fentanyl: 0% hydromorphone: 0% | RR < 10/min, SpO2 < 90% |
| Attia, 1986(20) (20) | Prospective | morphine | 0% | Apnea |
| Krane, 1987(25) (46) | Prospective | morphine | 0% | RR<10/min |
| Lovstad, 1997(28) (100) | Prospective | fentanyl | 0% | Treatment with rescue medication |
| Giaufre, 1996b (22) (15,013) | Prospective survey | various | 0.006% | Apnea |
| Shayevitz, 1996(30) (54) | Retrospective case control | morphine | E: 0%
IV: 0% |
Delayed extubation, reintubation, naloxone use |
| Valley, 1991(29) (138) | Retrospective | morphine | 8% | Apnea, desaturation, bradycardia, decreased RR, treated with stimulation, intubation, or nalaxone |
| Flandin- Blety, 1995(21) (7200) | Retrospective questionnaire | various | 0% | Various, not specified |
| Williams, 2003(24) | Retrospective questionnaire | various | Overall: 0.1–5% | Various, not specified |
RCT = randomized controlled trial; IV = intravenous; RR = respiratory rate; SpO2 = arterial oxygen saturation; E = epidural.
a
Used intravenous morphine as supplementary analgesic.
b
Used mostly caudal blocks.
AU: PLS CHECK SUPERSCRIPTS AS THEY HAD TO BE CHANGED TO CONFORM TO JOURNAL STYLE. ALSO, IS THE ADDITION OF REF # TO COLUMN 1 OKAY WITH YOU?