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The potential risk of adverse effects from hypoventilation due to intravenous and/or intrathecal narcotic administration was recognized. Sauk Prairie Memorial Hospital and Clinics understood the limitations with the use of pulse oximetry and respiratory assessment in detecting adequate ventilation. Evidence has shown that capnography is the best indicator of respiratory depression. This article describes the implementation of monitoring program for high risk patients. Early recognition of respiratory depression via capnography has enabled Sauk Prairie Memorial Hospital to safely care for patients having intravenous and intrathecal narcotics.