Abstract
Abstract Background : Naloxone is a morphine antagonist usually given to reverse or to prevent the respiratory depression induced by morphine overdose. Case presentation : A 61-year-old man underwent a lower abdominal resection for rectal carcinoma. Epidural morphine 2 mg diluted in 10 ml of normal saline was prescribed. Twenty milligrams of morphine instead of 2 mg morphine were given by mistake. The patient was intensively observed in the post-anaesthetic room without giving naloxone for 40 hours. The respiratory rate and arterial blood gases were monitored. The respiratory rate was mildly depressed (below 16 breaths/min) for as long as 20 hours. The peak of the respiratory depression was observed after 2–3 hours with a respiratory rate of 12 breaths per minute and PaCO2 of 56.3 mmHg. The patient was almost 40 hours pain free. No nausea, vomiting and pruritus was noted, but urine retention was observed for 26 days.
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