Sidi A, Davidson J T, Behar M, Olshwang D
Anaesthesia. 1981 Nov;36(11):1044-7. doi: 10.1111/j.1365-2044.1981.tb08679.x.
A case of central nervous system depression which developed 7 hours after an intrathecal injection of 4 mg of morphine is described. The patient lapsed into coma with bradypnoea and "pin-point' pupils and there was no response to naloxone 0.4 mg. Treatment was continued for 3 hours. No postoperative analgesics were required for 126 hours. The problems associated with the use of intrathecal opiates are reviewed, delay in onset being the usual feature. Use of hyperbaric solutions of the narcotic and maintenance of a head-up posture may protect against respiratory depression.
本文描述了一例在鞘内注射4毫克吗啡7小时后出现中枢神经系统抑制的病例。患者陷入昏迷，呼吸缓慢，瞳孔呈“针尖样”，对0.4毫克纳洛酮无反应。治疗持续了3小时。126小时内无需术后镇痛。文中回顾了鞘内使用阿片类药物相关的问题，起效延迟是常见特征。使用麻醉药的高压溶液和保持头高位可能预防呼吸抑制。
