Newly Published
Correspondence  |   November 2019
Opioid-induced Miosis Is Unaltered by Obstructive Sleep Apnea: Reply
Author Notes
  • Washington University in St. Louis, School of Medicine, St. Louis, Missouri. montana@wustl.edu
  • Research Support: Supported by a Faculty Development Award from the Pharmaceutical Research and Manufacturers of America Foundation and the Washington University in St. Louis Department of Anesthesiology, St. Louis, Missouri.
    Research Support: Supported by a Faculty Development Award from the Pharmaceutical Research and Manufacturers of America Foundation and the Washington University in St. Louis Department of Anesthesiology, St. Louis, Missouri.×
  • Michael M. Todd, M.D., served as Handling Editor for this correspondence.
    Michael M. Todd, M.D., served as Handling Editor for this correspondence.×
  • Accepted for publication October 10, 2019.
    Accepted for publication October 10, 2019.×
Article Information
Correspondence
Correspondence   |   November 2019
Opioid-induced Miosis Is Unaltered by Obstructive Sleep Apnea: Reply
Anesthesiology Newly Published on November 13, 2019. doi:https://doi.org/10.1097/ALN.0000000000003042
Anesthesiology Newly Published on November 13, 2019. doi:https://doi.org/10.1097/ALN.0000000000003042
I appreciate the interest that Drs. Webber and Karan showed in our study of opioid sensitivity in children with sleep apnea1  and welcomed their comments. They note that opioid-induced miosis and opioid-induced respiratory depression are distinct effects. I agree and explicitly stated as much in the abstract, noting that although remifentanil administration resulted in miosis, “the administered dose of remifentanil did not affect respiratory rate or end-expired carbon dioxide in either group.” Nowhere in the article do I make the claim that my study addresses the paramount concern of respiratory depression in children with or without obstructive sleep apnea. However, our study failed to find a difference in opioid-induced miosis between patients with and without a clinical diagnosis of obstructive sleep apnea. This was surprising and raises the need to assess other opioid-mediated effects in patients with and without obstructive sleep apnea, especially respiratory depression.