RESUMO
A 47-year-old woman was diagnosed with secondary progressive multiple sclerosis, and was treated with intrathecal morphine for chronic pain via a slow-release subcutaneous pump. She accidentally received a 35-ml (510 mg) bolus injection of morphine by this route, which led to status epilepticus. She was treated with continuous intravenous naloxone infusion, and with medication to control hypertension and stop the seizure activity. The outcome was excellent, and the patient returned to her neurological baseline. This report describes the complications and the successful treatment of intrathecal morphine overdose. In order to prevent these serious errors, it is vital that only care providers who are proficient with these devices perform the refilling procedure.
Assuntos
Analgésicos Opioides/intoxicação , Feminino , Humanos , Injeções Espinhais , Erros de Medicação , Pessoa de Meia-Idade , Morfina/intoxicação , Esclerose Múltipla Crônica Progressiva/complicações , Naloxona/administração & dosagem , Antagonistas de Entorpecentes/administração & dosagem , Overdose de Drogas/tratamento farmacológico , Dor/tratamento farmacológicoRESUMO
OBJECTIVE@#To investigate the distribution of mophine in organs in cases with morphine poisioning to select ideal organs for immunohistochemical derection.@*METHODS@#Localization and half quantitation of morphine in the brain, the kidney, the heart, and the liver were studied in 8 cases with morphine poisoning by immunohistochemical SP method.@*RESULTS@#Morphine was mainly detected in the cytoplasm of certain parenchymal cells of the organs. The distribution varied greatly with different cases and organs. In the brain and kidney, morphine-positive cells could be easily found.@*CONCLUSION@#The kidney and brain may be the ideal organs for sampling in suspected morphine poisoning cases with.