Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report

Opioid-induced respiratory depression (OIRD) is a serious threat that can lead to brain damage and death. Morphine is a commonly used opioid for postoperative pain management. However, the window during which patients are at risk of OIRD, as described in the literature, is largely based on the drug’...

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Main Authors: Islam Mukhtar, Omar Mudawi, Abdulrahman H. Alashkar, Raed Ali Abuajamieh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-10-01
Series:Dr. Sulaiman Al Habib Medical Journal
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Online Access:https://journals.lww.com/10.4103/DSHMJ.DSHMJ_75_24
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author Islam Mukhtar
Omar Mudawi
Abdulrahman H. Alashkar
Raed Ali Abuajamieh
author_facet Islam Mukhtar
Omar Mudawi
Abdulrahman H. Alashkar
Raed Ali Abuajamieh
author_sort Islam Mukhtar
collection DOAJ
description Opioid-induced respiratory depression (OIRD) is a serious threat that can lead to brain damage and death. Morphine is a commonly used opioid for postoperative pain management. However, the window during which patients are at risk of OIRD, as described in the literature, is largely based on the drug’s pharmacokinetics rather than actual clinical experiences. For morphine, OIRD is generally noted to occur within 5–72 min following administration. In this case, we present the case of a 73-year-old female who underwent open herniorrhaphy and developed respiratory depression 5 h after receiving an intravenous (IV) dose of morphine. The diagnosis of OIRD was confirmed by a positive response to naloxone. Defining a window during which patients are at risk of developing respiratory impairment after opioid administration has significant practical implications for the management of postoperative patients. Based on its half-life and our clinical experience, healthy patients receiving a therapeutic dose of IV morphine may develop OIRD for up to 6 h following administration. During this period, close monitoring is strongly recommended to ensure early detection and intervention if respiratory depression occurs.
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publisher Wolters Kluwer Medknow Publications
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series Dr. Sulaiman Al Habib Medical Journal
spelling doaj-art-97bc2d3e16a04214a29b90faaa1f68442025-08-21T05:06:29ZengWolters Kluwer Medknow PublicationsDr. Sulaiman Al Habib Medical Journal2666-819X2590-33492024-10-016424925110.4103/DSHMJ.DSHMJ_75_24Delayed Presentation of Morphine-Induced Respiratory Depression: A Case ReportIslam MukhtarOmar MudawiAbdulrahman H. AlashkarRaed Ali AbuajamiehOpioid-induced respiratory depression (OIRD) is a serious threat that can lead to brain damage and death. Morphine is a commonly used opioid for postoperative pain management. However, the window during which patients are at risk of OIRD, as described in the literature, is largely based on the drug’s pharmacokinetics rather than actual clinical experiences. For morphine, OIRD is generally noted to occur within 5–72 min following administration. In this case, we present the case of a 73-year-old female who underwent open herniorrhaphy and developed respiratory depression 5 h after receiving an intravenous (IV) dose of morphine. The diagnosis of OIRD was confirmed by a positive response to naloxone. Defining a window during which patients are at risk of developing respiratory impairment after opioid administration has significant practical implications for the management of postoperative patients. Based on its half-life and our clinical experience, healthy patients receiving a therapeutic dose of IV morphine may develop OIRD for up to 6 h following administration. During this period, close monitoring is strongly recommended to ensure early detection and intervention if respiratory depression occurs.https://journals.lww.com/10.4103/DSHMJ.DSHMJ_75_24morphineopioidpostoperativerespiratory depression
spellingShingle Islam Mukhtar
Omar Mudawi
Abdulrahman H. Alashkar
Raed Ali Abuajamieh
Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report
Dr. Sulaiman Al Habib Medical Journal
morphine
opioid
postoperative
respiratory depression
title Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report
title_full Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report
title_fullStr Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report
title_full_unstemmed Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report
title_short Delayed Presentation of Morphine-Induced Respiratory Depression: A Case Report
title_sort delayed presentation of morphine induced respiratory depression a case report
topic morphine
opioid
postoperative
respiratory depression
url https://journals.lww.com/10.4103/DSHMJ.DSHMJ_75_24
work_keys_str_mv AT islammukhtar delayedpresentationofmorphineinducedrespiratorydepressionacasereport
AT omarmudawi delayedpresentationofmorphineinducedrespiratorydepressionacasereport
AT abdulrahmanhalashkar delayedpresentationofmorphineinducedrespiratorydepressionacasereport
AT raedaliabuajamieh delayedpresentationofmorphineinducedrespiratorydepressionacasereport