Sauter K, Kaufman H H, Bloomfield S M, Cline S, Banks D
Department of Neurosurgery, West Virginia University, Morgantown.
J Neurosurg. 1994 Jul;81(1):143-6. doi: 10.3171/jns.1994.81.1.0143.
The case is reported of a 45-year-old woman who was being treated for chronic back and right leg pain with intrathecal morphine administered via a subcutaneous continuous-infusion device. She received an accidental 450-mg bolus injection of morphine intrathecally and developed hypertension, status epilepticus, intracerebral hemorrhage, and respiratory failure. Treatment with continuous intravenous naloxone infusion, lumbar catheter drainage of cerebrospinal fluid, and control of hypertension and status epilepticus resulted in an excellent outcome with return to neurological baseline. Care providers who refill pump reservoirs with morphine must be knowledgeable about these devices and the life-threatening consequences associated with errors in refilling them. This case describes the complications and successful treatment of high-dose intrathecal morphine overdose.
报告了一例45岁女性病例，该患者因慢性背痛和右腿疼痛，通过皮下持续输注装置鞘内注射吗啡进行治疗。她意外鞘内注射了450毫克大剂量吗啡，随后出现高血压、癫痫持续状态、脑出血和呼吸衰竭。通过持续静脉输注纳洛酮、腰椎导管引流脑脊液以及控制高血压和癫痫持续状态进行治疗，患者恢复至神经学基线水平，预后良好。负责用吗啡重新填充泵储液器的医护人员必须了解这些装置以及与重新填充错误相关的危及生命的后果。本病例描述了大剂量鞘内吗啡过量的并发症及成功治疗情况。
