Colonic pseudoobstruction associated with patient-controlled analgesia after total joint arthroplasty.
Patient-controlled analgesia (PCA) is a concept that permits patients to administer a prescribed dose of narcotic to themselves when they experience pain. Six patients developed colonic pseudoobstruction after the use of morphine sulfate administered via a PCA infuser. Early recognition and prompt treatment make this a transient, reversible illness. Treatment includes discontinuing the use of the PCA morphine, eliminating oral intake, ensuring adequate hydration and electrolyte balance, placing a nasogastric tube, rolling the patient, and closely observing for signs and symptoms of worsening colonic distention and possible rupture.
Chambers
H G
HG
Orthopaedic Surgery Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234.
Silver
S M
SM
Bucknell
A L
AL
D000368:Aged; D003108:Colonic Diseases / Q000209:etiology*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007260:Infusion Pumps; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010149:Postoperative Pain / Q000517:prevention & control*; D011183:Postoperative Complications; D012646:Self Administration
D009020:Morphine