Postoperative Clinical Monitoring After Morphine Administration: A Retrospective Multicenter Practice Survey.
Curr Drug Saf
; 14(2): 140-146, 2019.
Article
en En
| MEDLINE
| ID: mdl-30843492
ABSTRACT
BACKGROUND:
The objective of this survey was to describe the clinical monitoring practically used after intravenous, subcutaneous or neuraxial (epidural or intrathecal) administration of morphine.METHODS:
It was a descriptive, retrospective, multicenter (10 hospitals) survey based on the medical charts' analysis, which evaluated the postoperative clinical monitoring after morphine administration.RESULTS:
Morphine was delivered intravenously (69%), intrathecally (19%), epidurally (10%) and/or subcutaneously (12%). Clinical monitoring protocols and protocols for the management of side effects were both present in 60% (n=6/10), only one of the two types of protocols in 10% (n=1/10) and both absent in 30% (n=3/10). Protocols for the management of respiratory depression and consciousness evaluation were present in 70% of cases (n=7/10). These events were reported on medical records without any prescription or protocol in 35% (n=14/40) and 37,5% (n=15/40) respectively. Prescriptions for respiratory rate evaluation and clinical monitoring of consciousness were in agreement with only 20% of the medical data and medical records. Different levels of respiratory rate were observed 43% (n=3/7) below 8/min, 43% (n=3/7) below 10/min and 14% (n=1/7) below 12/min. Clinical monitoring was not performed in 31% (n=31/100) for consciousness and in 35% (n=35/100) for respiratory rate. Pulse oximeter was used in 48% (n=48/100) of patients. Capnography was never used. Respiratory depression occurred in 1% (n=1/100) of cases.CONCLUSION:
This survey emphasizes an important disparity in the prescription of medical monitoring and a lack of use of protocols when morphine is administered. It demonstrates the need for a standardization of protocols according to the existing guidelines.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Analgésicos Opioides
/
Morfina
Tipo de estudio:
Guideline
/
Observational_studies
/
Qualitative_research
Límite:
Aged
/
Aged80
/
Humans
Idioma:
En
Revista:
Curr Drug Saf
Año:
2019
Tipo del documento:
Article
País de afiliación:
Canadá