The Role of Integrated Pulmonary Index Monitoring Versus Capnography for the Detection of Opioid Induced Respiratory Depression
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Problem under investigation: Despite the frequency of opioid use throughout the perioperative period, there are no universally accepted guidelines to direct monitoring for respiratory depression. Objective: Compare the effectiveness of the Integrated Pulmonary Index (IPI) to end-tidal carbon-dioxide (EtCO2) monitoring in detecting Opioid Induced Respiratory Depression (OIRD). Background Literature/Theoretical Framework: Kurt Lewin’s change theory provides the theoretical basis needed to implement the findings of this study. Project Methods: Obtain preoperative IPI and EtCO2 baselines from the subjects and monitor their number of OIRD instances postoperatively. Results: There is no correlation between IPI and EtCO2 monitoring. A positive correlation exists between IPI and SpO2. There was no difference in precision found between SpO2 and IPI. Potential Significance: The lack of evidence on which electronic monitoring systems perform best, and uncertainty over when patients are actually experiencing OIRD necessitates the need for more accurate monitoring devices in the Post-Anesthesia Care Unit (PACU). Implications: Surgical facilities should consider IPI as an additional monitoring instrument in the PACU to prevent adverse outcomes associated with OIRD. Conclusion: IPI and SpO2 are effective monitoring tools for detecting OIRD postoperatively. Further investigation into multimodal pain management is warranted due to decrease the occurrences of OIRD.