Serious Adverse Events after a Single Shot of Intrathecal Morphine: A Case Series and Systematic Review

Table 1

Patients’ characteristics.

Patient	Age-gender-type of laparoscopic surgery	Dose of ITM (mcg)	Time between ITM and symptoms (hours)	Duration of symptoms (hours)	Vital signs when symptoms were detected^	Class of SAE	Treatment	ICU admission	Length of hospital stay (days)
1	80-F-right hemicolectomy	5000	5	19	E3M6V5, 6 brpm, 7.1 kPa, 97%, 2 L min^−1, 118/54, 71 bpm	S, RD	100 mcg naloxone, at 10 and 22 hours after ITM injection	No	8
2	73-M-rectosigmoid resection	5000				None		No	8
3	72-M-rectosigmoid resection	4000	4	24	E4M6V5, 17 brpm, 100%, 1 L min^−1, 102/31, 54 bpm	H	Norepinephrine-infusion for 24 hours	Yes	4
4	74-F-right hemicolectomy	5000	2	36	E2M5V2, 8 brpm, 7.3 kPa, <70%, 0 L min^−1, 100/65, 70 bpm	S, RD	Oxygen and naloxone-infusion for 36 hours	Yes	5
5	68-F-right hemicolectomy	3000				None		No	4
6	63-M-sigmoid resection	3000	13	6	E2M5V2, 12 brpm, 8.2 kPa, 97%, 1 L min^,−1, 164/95, 94 bpm	S, RD	100 mcg naloxone	No	4

Received benzodiazepines preoperatively. ^Displayed as Glasgow Coma Score, respiratory rate, pCO₂, SaO₂, supplemental oxygen, noninvasive blood pressure, and heart rate. Bpm: beats per minute; brpm: breaths per minute; F: female; H: hypotension, ICU: Intensive Care Unit; ITM: intrathecal morphine, M: male, RD: respiratory depression, and S: somnolence.