Unexpected complication of successful nerve block. Morphine induced respiratory depression precipitated by removal of severe pain.
A case is reported of a 76-year-old man with a right-sided mesothelioma who required large doses of oral narcotics to control his severe chest pain. After a successful chlorocresol intrathecal nerve block, respiratory failure was induced by doses of oral morphine at the same level as those used before the block, and also by substantially smaller doses. A considerable reduction in analgesic requirements may be possible following non-drug intervention to relieve pain and may be essential in patients with compromised respiratory function. This observation emphasises the importance of pain as a potent stimulator of the respiratory centre in patients with reduced respiratory reserve who are receiving narcotic drugs.
D000368:Aged; D004334:Drug Administration Schedule; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D009407:Nerve Block / Q000009:adverse effects*; D059408:Pain Management; D012131:Respiratory Insufficiency / Q000139:chemically induced*
D009020:Morphine