[Postoperative opioid overdose due to patient-controlled analgesia by proxy]

Area of Science:

• Anesthesiology
• Pharmacology
• Patient Safety

Background:

• Patient-controlled analgesia (PCA) is a common method for managing postoperative pain.
• Intravenous morphine PCA is frequently used for effective pain relief after surgery.
• PCA use is associated with potential complications, including respiratory depression.

Observation:

• A 73-year-old Somalian male patient developed unresponsiveness after abdominal surgery.
• The patient was receiving intravenous morphine PCA, with his son acting as interpreter.
• The patient's son admitted to operating the PCA device for the patient.

Findings:

• The patient experienced respiratory depression, indicated by low oxygen saturation.
• Naloxone administration was required to reverse the opioid effects.
• PCA by proxy, facilitated by a language barrier, was identified as the cause.

Implications:

• PCA by proxy poses significant risks, including overdose and respiratory compromise.
• Healthcare providers must address language barriers and health literacy in PCA management.
• Implementing robust safety protocols is crucial to prevent PCA-related adverse events.