Medical Complication
Conditions
Keywords
Opioid-induced respiratory depression, Postoperative opioid, Opioid-naïve patients, Chronic opioid patients, Desaturation, Bradypnea, Continuous monitoring, Patient safety
Brief summary
Aim: To describe the duration of desaturation and bradypnea in postoperative opioid-naïve and chronic opioid patients. Patients: 691 patients included from two previous WARD (Wireless Assessment of Respiratory and circulatory Distress) projects. Outcome: Respiratory deviations four hours after opioid administration
Detailed description
Aim: To describe the duration of desaturation and bradypnea in postoperative opioid-naïve and chronic opioid patients within the first four hours following opioid administration in addition to the chronic dose, using a continuously wireless monitoring system. Patients: 691 patients included from two previous WARD (Wireless Assessment of Respiratory and circulatory Distress) projects. Continuous wireless monitoring data of peripheral tissue oxygenation (SpO2) and respiratory rate (RR) was conducted in postoperative patients. Data were stratified into opioid-naïve and chronic opioid patients, based on their preoperative opioid history. Patients who did not receive opioids postoperatively were served as the control group. Data was evaluated one hour before and four hours after opioid administration. The primary outcome was the cumulative duration of SpO2 \<88%.
Interventions
Wireless monitoring system that provided continuous, non-invasive collection of their vital signs, including peripheral oxygen saturation (SpO2) and respiratory rate (RR), for up to 92 hours following surgery or until discharge. The respiratory rate was monitored via FDA-approved Isansys Lifetouch electrocardiogram (ECG) patch, which was placed on the left side of the chest. SpO2 levels were continuously recorded using the Nonin WristOx 3150, a wrist-mounted finger oximeter.
Sponsors
Bispebjerg Hospital
Rigshospitalet, Denmark
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Inclusion criteria
* Patients from studies WARD Surgery Observational \[gov: NCT03491137\] * The control group from WARD Surgery Randomized Controlled Trial \[gov: NCT04640415\]
Exclusion criteria
* Less than 30 minutes of continuous monitoring data within the 60-minute window prior to opioid administration * Less than 120 minutes (\<50% of theoretical maximum) of monitoring data available during the four-hour observation period * Patients who received transdermal fentanyl as postoperative opioid * Patients with a baseline saturation or respiratory rate below the prespecified thresholds * Patients with a BMI of ≥40 or diagnosed with COPD were excluded in the analysis of SpO2 \<92%
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| SpO2 <88% in the four hours following opioid administration | four hours following opioid administration |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory deviations four hours after opioid administration | four hours following opioid administration | SpO2 \<92%, \<88 %, \<85%, \<80% and respiratory rate ≤11 min-1, ≤8 min-1, ≤5 min-1 |
Countries
Denmark
Outcome results
None listed