Levels of morphine and metabolites in CSF during respiratory depression after intraventricular morphine injection.
We report a case of respiratory depression after intracerebroventricular morphine administration of a dose inadvertently 10 times greater than the typical daily dose. At the time of the respiratory dysfunction, the concentrations of morphine and its metabolites in cerebrospinal fluid (CSF) and plasma samples were determined. On comparison of these results with previous clinical studies in which there was no respiratory depression, no relationship was found between the occurrence of respiratory depression and the concentration of morphine or its metabolites in the CSF. The occurrence and characteristics of respiratory depression may be related to the concentrations of morphine and its metabolites in bulbar tissue.
Langlade
A
A
Département d'Anesthésie Réanimation, Hôpital Lariboisière, Paris 75010 France Centre de Traitement de la Douleur, Hôpital Lariboisière, Paris 75010 France INSERM U26, Hôpital Fernand Widal, Paris 75010 France.
Serrie
A
A
Sandouk
P
P
Thurel
C
C
Cunin
G
G
D000230:Adenocarcinoma / Q000150:complications; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000150:complications; D005260:Female; D006801:Humans; D007276:Injections, Intraventricular; D008508:Medication Errors; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects* / Q000134:cerebrospinal fluid; D009270:Naloxone / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000503:physiopathology
D009270:Naloxone; D009020:Morphine