Masoud P J, Green C D
Can Anaesth Soc J. 1982 Jul;29(4):377-80. doi: 10.1007/BF03007529.
In summary, a patient was rapidly injected by error with morphine sulphate 60 mg epidurally. Left bundle branch block and ST segment depression signalled a problem. Respiratory depression occurred 15 minutes later. sympathetic blockade of the lower extremities was not detected. Injections of naloxone reversed the left bundle branch block, and respiratory depression but appeared to be cumulative and resulted in severe pain. A continuous naloxone infusion was effectively titrated to minimize respiratory depression for 19 hours without reversing analgesia. Twenty-four hours after epidural injection, the neurological examination was normal. Epidural morphine analgesia persisted for approximately 38.5 hours.
总之，一名患者被误将60毫克硫酸吗啡快速硬膜外注射。左束支传导阻滞和ST段压低提示出现问题。15分钟后发生呼吸抑制。未检测到下肢交感神经阻滞。注射纳洛酮逆转了左束支传导阻滞和呼吸抑制，但似乎具有累积效应，并导致剧痛。持续输注纳洛酮可有效滴定，在不逆转镇痛效果的情况下将呼吸抑制降至最低达19小时。硬膜外注射24小时后，神经学检查正常。硬膜外吗啡镇痛持续约38.5小时。
