產科麻醉中蛛網膜下腔注入morphine引發急性精神異常

Acute Mental Disturbance after Intrathecal Morphine in Obstetric Anesthesia -A Case Report

於局部麻醉劑中加入微小劑量之morphine合併注入蛛網膜下腔用來幫忙手術後止痛，已在產科麻醉領域廣為流行。一個33歲足月孕婦以0.15mgmorphine加入的13mg0.5%bupivacaine作脊髓麻醉，進行剖腹生產手術。麻醉之後4小時病患出現怠性精神異常表現，在接受noloxone注射數分鐘後其精神狀態迅速恢復正常。

Adding a small single dose of morphine to local anesthetic agent injected simultaneously into the subarachnoid space for postoperative analgesia has prevailed in obstetric anesthesia for decades. We reported an unusual complication which developed after 4 hours with acute mental status change in a 33-year-old full term parturient scheduled for cesarean section receiving 0.15 mg preservative-free morphine and 13 mg plain 0.5% bupivacaine together for spinal anesthesia. It was promptly reversed by naloxone.