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Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

[Acute respiratory distress subordinate to a morphine overdose during a frail elderly patient controlled analgesia]

A Ades1, V Compère, C Abriou

  • 1Département d'anesthésie-réanimation et Samu, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.

Annales Francaises D'Anesthesie Et De Reanimation
|April 14, 2009
PubMed

Insights

An 85-year-old patient experienced respiratory distress from morphine overdose during patient-controlled analgesia (PCA) post-hip surgery. This highlights the need to adjust PCA morphine dosage based on kidney function to prevent overdose.

Area of Science:

  • Anesthesiology
  • Pharmacology
  • Geriatrics

Background:

  • Patient-controlled analgesia (PCA) is common for post-operative pain management.
  • Morphine overdose can lead to serious complications, including respiratory depression.

Purpose of the Study:

  • To report a case of morphine overdose in an elderly patient receiving PCA after total hip arthroplasty.
  • To emphasize the importance of individualized dosing in PCA, considering patient-specific factors.

Main Methods:

  • Case report of an 85-year-old male patient.
  • Analysis of patient-controlled analgesia (PCA) pump usage and patient's clinical presentation.
  • Assessment of renal function using the Cockcroft and Gault formula.

Main Results:

  • The patient developed acute respiratory distress due to morphine overdose four hours post-surgery.
  • No errors in PCA pump programming or administration were identified.
  • Accumulation of morphine was suspected due to the patient's age and renal failure.

Conclusions:

  • Optimal morphine dosing for PCA must consider estimated glomerular filtration rate (eGFR) in elderly patients.
  • Renal impairment can significantly affect morphine clearance, increasing overdose risk.
  • Individualized PCA protocols are crucial for safe pain management in vulnerable patient populations.

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