TREATMENT OF HIGH-DOSE INTRATHECAL MORPHINE OVERDOSE - CASE-REPORT

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 accide ntal 450-mg bolus injection of morphine intrathecally and developed hy pertension, status epilepticus, intracerebral hemorrhage, and respirat ory failure. Treatment with continuous intravenous naloxone infusion, lumbar catheter drainage of cerebrospinal fluid, and control of hypert ension and status epilepticus resulted in an excellent outcome with re turn to neurological baseline. Care providers who refill pump reservoi rs with morphine must be knowledgeable about these devices and the lif e-threatening consequences associated with errors in refilling them. T his case describes the complications and successful treatment of high- dose intrathecal morphine overdose.