| Clinical Observation of the CNS Depression following Intrathecal Injection of Morphine . |
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Chi Hyo Kim, Kyung Han Kim, Choon Hi Lee |
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Department of Anesthesiology, College of Medicine, Ewha Womans University, Seoul, Korea. |
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| Abstract |
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It had been demonstrated that injection of small doses of morphine into the subarachnoid space produces potent analgesia without signs of central nervous system depression. Recently, however, we have had experience with 3 cases of central nervous system depression after intrathecal injection of morphine. Small doses of morphine( two cases: 2mg, one case: 1mg in 1.0% tetracaine with 1:1000 epinephrine 0.2ml) were given intrathecally to 3 patients undergoing surgical procedures. Approximately 6 to 7 hours after administration of the local anesthetic with morphine intrathecally, slow respiration, sleepiness and pinpoint pupils, signs of central nervous system depression, developed. Afterwards, intravenous naloxone and doxapram were given with immediate reversal of all symptoms without sequele. However, the safe dose of intrathecal morphine has yet to be defined in further study. |
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