[Severe differed respiratory depression after intrathecal administration of morphine and clonidine on a 70-year-old patient].
We report a case of severe and differed respiratory depression to a 70-year-old patient after spinal anaesthesia for prostatic adenomectomy. Ten milligram of bupivacaine, 30 microg of clonidine and 100 microg of morphine has been administrated intrathecally. The anaesthesia has lasted 4h and, 16h after the induction, the patient had a respiratory depression with bradypnea (5c/min), hypoxia (SpO(2) 80%) and sedation (scale 3 of Wilson). The evolution was favourable after intravenous injection of naloxone and oxygenotherapy. The use of low dose intrathecal morphine can involve a respiratory depression. Intrathecal association of morphine and clonidine must be careful used among old patients and require a monitoring during the first 24h.
Ouro-Bang'na Maman
A F
AF
Service d'Anesthésie Réanimation, CHU de Lomé, Université de Lomé, Agbalépédogan, Lomé, Togo.
Sama
H D
HD
Alassani
F
F
Egbohou
P
P
Chobli
M
M
D000236:Adenoma / Q000601:surgery; D000316:Adrenergic alpha-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D003000:Clonidine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D000860:Hypoxia / Q000139:chemically induced / Q000378:metabolism; D007278:Injections, Spinal; D008297:Male; D009020:Morphine / Q000009:adverse effects* / Q000627:therapeutic use; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D011471:Prostatic Neoplasms / Q000601:surgery; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000628:therapy; D015656:Respiratory Mechanics / Q000187:drug effects
D000316:Adrenergic alpha-Agonists; D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D009292:Narcotic Antagonists; D009270:Naloxone; D009020:Morphine; D003000:Clonidine