This is questions for practitioners from outside USA, because morphine chloride is not available in USA
I observed late respiratory depression in 3 patients with epidural morphine administration. Most obvious findings were the respiratory acidosis, hypotension, bradycardia and blurred consciousness.
Usually, intrathecal infusion pumps used as drug morphine. They have very good results if handled properly.
Drs. Uzman and Collazo Chao, what type of morphine do you use in Turkey and Spain? In USA we have so called preservative free morphine sulfate. I also have experience with spinal and epidural morphine chloride during my work in Europe. Does your morphine contains EDTA (stabilizer)? Thank you.
0.5 mg intratecal or 2 mg epidural are safety doses tha can be administered in a normal adult (60-80 kg). Allways preservative free. Be aware about others drugs prescribed in the postop like BZD o other opioids. Always monitorize level of conciousness, respiratory rate and SpO2.
Drs. Vilaplana and Collazo Chao, thank you so much for your response. Many places in Eastern Europe are afraid to use spinal and epidural morphine because their morphine is different than American morphine. What they have is probably identical to morphine that you have in Spain. What is the chemical composition of your morphine? Does it contains something to stabilize pH? Does it contains anti-oxidizer? I would like to see "package insert" (paper that comes with medication) for your morphine. My email is [email protected] the best of my knowledge no-one ever described any neurological complications with any type of spinal or epidural morphine. Thank everyone for response.
Here you have an attached file with the prospect of the drug. It can be found on the internet.
Best regards.
We are in our hospital for post-operative analgesia in children
15mcg / kg, we apply an epidural 2-3 mg in adults.
If we use 300 mcg intrathecal administration. We never met complications.
But you need to pay attention to where the hydrophilic opioid morphine. Rostral spread can be seen. And starting late effects.
We morphine dose in adults max: we apply an epidural dose of 3 mg.
Intrathecal dose of 0.5 mg
we use intrathecal morphine (preservative free) for postop pain relief after elective cardiac surgery in a dose of 0.5 to 1.5 mg depending on the patient. These patients are in ITU postop anyway hence monitoring respiratory depression is not an issue.