クモ膜下腔微量モルフィン注入で術後呼吸停止をきたした1症例

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A 43-year-old, healthy woman underwent an hysterectomy for myoma of the uterus under spinal anesthesia. Spinal anesthesia was performed at the L<SUB>2-3</SUB> interspace, with 2.5 ml of 0.3 % hyperbaric dibucaine and 0.5 mg of morphine was additionally injected. The operation was uneventful. About 7 hours after the injection, the patient was found to be comatose, apneic and cyanosed. Immediately, artificial ventilation was performed by the oral method and with the of an AMBU bag resuscitator. Doxapram was administered by, drip infusion, but severe respiratory depression continued for about 6 hours. This respiratory depression was considered due to the intrathecal morphine administration. When intrathecal morphine (even a minimal dose) is applied as a postoperative pain reliever, extreme care must be paid to the occurrence of postoperative respiratory depression.
学校法人昭和大学・昭和医学会の論文