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Morphine-induced ventilatory failure after spinal cord compression.

F Quevedo1, D Walsh

  • 1Palliative Medicine Program, Cleveland Clinic Foundation, OH 44195, USA.

Journal of Pain and Symptom Management
|September 15, 1999
PubMed
Summary
This summary is machine-generated.

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Sudden pain relief from advanced cancer spinal cord compression led to a morphine overdose. This highlights the need for caution with high opioid doses when pain pathways are interrupted.

Area of Science:

  • Oncology
  • Pain Management
  • Neurology

Background:

  • Metastatic cancer can cause severe pain due to epidural spinal cord compression.
  • Parenteral morphine is often used for managing such severe pain.

Observation:

  • A patient with metastatic cancer experienced severe pain due to epidural spinal cord compression, requiring high-dose parenteral morphine.
  • Neurological progression to complete cord compression led to sudden pain relief.
  • The patient subsequently developed acute respiratory depression, suggesting a relative morphine overdose.

Findings:

  • The hypothesis suggests that complete cord compression interrupted nociceptive pathways, relieving pain.
  • The previously therapeutic morphine dose became physiologically excessive after pain relief and neurological damage.

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Implications:

  • Caution is advised for patients on high opioid doses when disease status changes or pain-relieving interventions occur.
  • Monitoring for opioid toxicity is crucial during rapid pain relief in patients with advanced cancer and spinal cord compression.