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Cited by 452Patient Safety and Medication ErrorsAnesthesia and Sedative AgentsOpioid Use Disorder Treatment

The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.

Postoperative Opioid-induced Respiratory Depression: A Closed Claims Analysis

Open access
Lee, Lorri A., Caplan, Robert A., Stephens, Linda S., Posner, Karen L., Terman, Gregory W., Voepel-Lewis, Terri, Domino, Karen B.·2015·Anesthesiology
DOI 10.1097/aln.0000000000000564
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Abstract

AbstractAbstract: In a review of 357 acute pain claims from the Anesthesia Closed Claims Project database, 92 cases involved likely opioid-related respiratory depression. The vast majority of these injuries occurred within 24 h of surgery, and 97% were judged as preventable with better monitoring and response. Background: Postoperative opioid-induced respiratory depression (RD) is a significant cause of death and brain damage in the perioperative period. The authors examined anesthesia closed malpractice claims associated with RD to determine whether patterns of injuries could guide preventative strategies. Methods: From the Anesthesia Closed Claims Project database of 9,799 claims, three authors reviewed 357 acute pain claims that occurred between 1990 and 2009 for the likelihood of RD using literature-based criteria. Previously cited patient risk factors for RD, clinical management, nursing assessments, and timing of events were abstracted from claim narratives to identify recurrent patterns. Results: RD was judged as possible, probable, or definite in 92 claims (κ = 0.690) of which 77% resulted in severe brain damage or death. The vast majority of RD events (88%) occurred within 24 h of surgery, and 97% were judged as preventable with better monitoring and response. Contributing and potentially actionable factors included multiple prescribers (33%), concurrent administration of nonopioid sedating medications (34%), and inadequate nursing assessments or response (31%). The time between the last nursing check and the discovery of a patient with RD was within 2 h in 42% and within 15 min in 16% of claims. Somnolence was noted in 62% of patients before the event. Conclusions: This claims review supports a growing consensus that opioid-related adverse events are multifactorial and potentially preventable with improvements in assessment of sedation level, monitoring of oxygenation and ventilation, and early response and intervention, particularly within the first 24 h postoperatively.

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Research works printed but not linked: 2

  1. 2013, Results of the opioid knowledge assessment from the PA Hospital Engagement Network Adverse Drug Event Collaboration., PA Patient Saf Advis, 10, 19
  2. 2012, Postoperative monitoring—The Dartmouth experience., APSF Newsl, 27, 1

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Metadata

Authors
Lee, L. A., Caplan, R. A., Stephens, L. S., Posner, K. L., Terman, G. W., Voepel-Lewis, T., & Domino, K. B.
Affiliations
  • Virginia Mason Medical Center (US)
  • From the Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee (L.A.L.); Department of Anesthesiology, Virginia Mason Hospital and Seattle Medical Center, Seattle, Washington (R.A.C.); Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington (L.S.S., K.L.P., G.W.T., K.B.D.); and Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan (T.V.-L.).
Corresponding author
Lee, Lorri A.
ORCID
Venue
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-03
Volume
122
Issue
3
Pages
659-665
ISSN
0003-3022 (ISSN-L)
DOI
10.1097/aln.0000000000000564
OpenAlex
W1991187412
Semantic Scholar
0811af5773d2b84f6cd0f08b396f84c91095d106
Cited by
451
References
22
Citations by year
2026: 22 · 2025: 34 · 2024: 37 · 2023: 27 · 2022: 36 · 2021: 59 · 2020: 53 · 2019: 45 · 2018: 48 · 2017: 48 · 2016: 35 · 2015: 6
FWCI
78.87
Type
journal article
Language
en
Open access
Locations
  • Anesthesiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Department of Veterans Affairs
  • University of Texas System
  • Anesthesia Quality Institute
  • Society of Anesthesia and Sleep Medicine
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
opioid-induced respiratory depression, postoperative complications, sedation monitoring, nursing assessment, sleepiness, preventable adverse events
MeSH terms
Adult, Aged, Analgesics, Opioid, Anesthesia, Female, Humans, Insurance Claim Review, Male, Middle Aged, Postoperative Complications, Respiratory Insufficiency, Databases, Factual

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