Ventilatory arrest after a fluid challenge in a neonate receiving s.c. morphine

S.c. infusions of morphine have been advocated for postoperative analgesia in children, but experience with this technique is limited. We report a case in which an s.c. infusion of morphine given after operation to a neonate failed to provide acceptable analgesia until the child had been adequately...

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Bibliographic Details
Published inBritish journal of anaesthesia : BJA Vol. 75; no. 6; pp. 787 - 789
Main Authors Wolf, A R, Lawson, R A, Fisher, S
Format Journal Article
LanguageEnglish
Published Oxford Elsevier Ltd 01.12.1995
Oxford University Press
Oxford Publishing Limited (England)
Subjects
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Biological and medical sciences
Drug toxicity and drugs side effects treatment
Fluid Therapy
Humans
Infant, Newborn
Infusions, Parenteral
Medical sciences
Morphine - administration & dosage
Morphine - adverse effects
Pain, Postoperative - drug therapy
Pharmacology. Drug treatments
Respiratory Insufficiency - chemically induced
Toxicity: respiratory system, ent, stomatology
Human
Case study
Newborn
Respiratory disease
Perfusion
Toxicity
Morphine
Opiates
Subcutaneous administration
Respiratory depression
Narcotic analgesic
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Summary:S.c. infusions of morphine have been advocated for postoperative analgesia in children, but experience with this technique is limited. We report a case in which an s.c. infusion of morphine given after operation to a neonate failed to provide acceptable analgesia until the child had been adequately rehydrated. However, restoration of peripheral perfusion with a fluid challenge was followed by sudden ventilatory arrest which required resuscitation and naloxone infusion. This report emphasizes the dangers of giving morphine by a peripheral route in the dehydrated or hypovolaemic infant.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/75.6.787