title: [Myoclonus resulting from high-dose epidural and intravenous morphine infusion].
abstract: BACKGROUND
  Myoclonus is a possible side effect of opioid therapy, and have been described following systemic as well as spinal application.
  
  
  METHODS
  We report the case of a patient with metastatic carcinoma of the rectum who developed myoclonus following administration of high-dose epidural combined with iv morphine. This complication occurred with maximum daily doses of 300 mg epidurally and 80 mg intravenously and disappeared completely after dose reduction. Treatment trials are presented, the pathophysiology of the myoclonus is discussed.
  
  
  CONCLUSIONS
  For treatment of opioid-induced myoclonus a dose reduction or a change of the opioid should be considered as well as symptomatic treatment with benzodiazepines or baclofen.
authors.affiliation: Klinik und Poliklinik für Anästhesiologic und Operative Intensivmedizin, Universität zu Köln.
authors.forename: L
authors.initials: L
authors.lastname: Radbruch
authors.forename: D
authors.initials: D
authors.lastname: Zech
authors.forename: S
authors.initials: S
authors.lastname: Grond
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001418:Baclofen / Q000627:therapeutic use; D005260:Female; D018755:GABA Agonists / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008207:Lymphatic Metastasis; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D009207:Myoclonus / Q000139:chemically induced* / Q000188:drug therapy; D010148:Intractable Pain / Q000188:drug therapy; D012004:Rectal Neoplasms / Q000473:pathology / Q000503:physiopathology
chemical_list: D000701:Analgesics, Opioid; D018755:GABA Agonists; D009020:Morphine; D001418:Baclofen
vernacular_title: Myoklonien als Folge von hochdosierter epiduraler und intravenöser Morphininfusion.