Accidental Overdosage with Intrathecal Morphine. Therapy with IV Naloxone Alone

Intrathecal morphine overdose during combined spinal–epidural block for Caesarean delivery

“…Pomonis and colleagues 5 reported four cases of intrathecal morphine overdoses (15 mg), that occurred in patients undergoing orthopaedic operations under spinal anaesthesia and who necessitated mechanical ventilation despite naloxone infusion (the authors did not report the dose of naloxone). A third report, 4 described an 8 mg intrathecal morphine overdose that did not require mechanical ventilation, probably because of naloxone infusion (9.6 mg over 24 h). The common ®nding among these three reports is the late recognition of the intrathecal morphine overdoses (1.5±4 h after the event).…”

Oral Morphine Overdose in a Cancer Patient Antagonized by Prolonged Naloxone Infusion

“…Several cases of accidental overdose with intrathecal [28][29][30][31][32] or epidural morphine 33 have been reported in various settings, including dysfunction of a patient-controlled analgesia device, 34 but most cases have been successfully treated with varying duration of naloxone infusion. There are few reports of overdose with oral morphine; Poklis et al 35 reported the death of an 8-year-old child with accidental overdose of oral morphine, and Chan et al 36 reported a case of unexpected effects of a single dose of oral morphine.…”