How to treat opioid related respiratory depression in the postoperative setting?
Opioids activating the µ receptor cause dose-dependent depression of respiration, primarily through a direct action on brainstem respiratory centers. Naloxone was introduced into clinical practice in the late 1960s. Side effects (increases in heart rate and blood pressure) and more serious complications (e.g., pulmonary edema) have been reported. The initial dose recommendations for naloxone in adults is 0.4 mg to 2 mg and is 0.1 mg/kg in pediatrics. Recent recommendations rather suggest titrating even lower doses in order to reverse the severe postoperative respiratory depression due to opioids, but not fully reverse its analgesic effect.