[Acute respiratory distress subordinate to a morphine overdose during a frail elderly patient controlled analgesia].
We describe a case-report of an 85-year-male patient with a patient-controlled analgesia (PCA) after a total hip arthroplasty. Four hours after surgery, acute respiratory distress secondary to a morphine overdose occurred, requiring an antagonisation with naloxone. Morphine overdose during a PCA was always caused by a wrong use of the pump. In this case-report, no mistake of programming or administration's use was found. Too important morphine's doses managed in comparison with the patient's age and his renal failure could explain this morphine's accumulation and the respiratory distress. This observation reminds us the obligation to determine the optimal posology in accordance with the rate of glomerular filtration estimated by Cockcroft and Gault formula for patients using a PCA.
Département d'anesthésie-réanimation et Samu, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
A
A
Ades
V
V
Compère
C
C
Abriou
O
O
Baert
V
V
Fourdrinier
B
B
Dureuil
D058186:Acute Kidney Injury / Q000150:complications* / Q000175:diagnosis; D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000627:therapeutic use; D000369:Aged, 80 and over; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D019644:Arthroplasty, Replacement, Hip; D004329:Droperidol / Q000008:administration & dosage / Q000627:therapeutic use; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D010149:Postoperative Pain / Q000188:drug therapy*; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000188:drug therapy / Q000628:therapy
D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine; D004329:Droperidol