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Journal of Anesthesia
Published in: Journal of Anesthesia 3/2016

01-06-2016 | Clinical Report

A case of delayed respiratory depression caused by accidental subcutaneous opioid infusion

Authors: Takuya Okada, Moritoki Egi, Hitoaki Sato, Yuki Nomura, Masako Okada, Shinichiro Izuta, Satoshi Mizobuchi

Published in: Journal of Anesthesia | Issue 3/2016

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Abstract

We report a case of delayed respiratory depression due to accidental subcutaneous opioid infusion. A healthy 33-year-old woman underwent orthopedic surgery under general anesthesia. Before the end of the operation, it was noticed that a part of the opioid infusion had been administered subcutaneously. About 15 min after tracheal extubation, the patient developed respiratory depression and loss of consciousness. The patient recovered with the use of jaw lift together with bag-valve-mask ventilation. We believe that accidental subcutaneous opioid accumulation may have caused the respiratory depression.
Literature
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Koo BN, Choi SH, Chun DH, Kil HK, Kim KJ, Min KT, Lee SJ. Respiratory depression caused by remifentanil infusion for postoperative pain control. Anesth Analg. 2006;103:1627–8.CrossRefPubMed
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Wolfson A, Swamidoss C. Accidental subcutaneous remifentanil infusion as a cause of delayed awakening after craniotomy. Anesthesiology. 2011; 2011: 919067.
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Sano H, Hashimoto M, Fuji T, Oe K, Suzuki T, Serada K. Case of delayed awakening after remifentanil leakage out of a vein. Masui. 2013;62:619–22.PubMed
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Cucchiaro G, Beers RA. Recrudescence of opioid effects after intraoperative remifentanil infusion complicated by infiltration of the intravenous catheter. Anesth Analg. 1998; 87:1458.
Metadata
Title
A case of delayed respiratory depression caused by accidental subcutaneous opioid infusion
Authors
Takuya Okada
Moritoki Egi
Hitoaki Sato
Yuki Nomura
Masako Okada
Shinichiro Izuta
Satoshi Mizobuchi
Publication date
01-06-2016
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 3/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-015-2137-2

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