jtgain’s question about anesthesia reminds me of the time I had wrist surgery and I received morphine fairly soon after waking up in the recovery room. All I remember is being unable to stay awake and nurse repeatedly waking me up to tell me to breathe. Each time I woke up I would drift back off hoping the nurse wasn’t going to run off to take care of something else.
Is this a normal reaction to morphine?
It’s a normal reaction to an overdose of morphine, that is, a dose which is too high for you as an individual. Morphine, unfortunately has no “right” dose, you have to guage it by response, some are sensitive, some are tolerant, it’s easy to give too much or too little.
Morphine depresses the brain’s respiratory drive, meaning that you breath more slowly, if you depress the respiratory drive too much, you stop breathing, which is how you die from heroin/morphine overdosage.
If you were to need morphine again I would tell someone about what happened the last time and make sure they started with a low dose.
Morphine is Ogs way of telling us He loves us.
Shermanater
Morphine on top of anesthesia most likely made you more groggy than a normal reaction would be. I can’t imagine the hospital giving you enough to OD and stop breathing. The nurse was most likely being cautious, which is her job.
Heroin addicts regularly nod out after fixing without an ill effects. But it only takes one fix too many to die and meet Og in person.“I can’t imagine the hospital” making any error is so false as to be laughable. There are 195,000 people a year dead due to hospital error in the US alone.
As irishgirl, who’s too modest to mention she’s a doctor, says, there is no safe dose unless you know the patient’s previous history with morphine. It’s not an easy formula like body weight times X micrograms per hour or similar, as some drugs are. Even a modest dose could kill one person and not touch the pain of his roommate. Now, they’re not going in entirely blind, but I can absolutely see how a touch too much would mean the recovery room nurse is going to be watching you like a hawk for signs of reduced frequency of breathing and/or slowing of the heart rate (bradycardia or brachycardia).
If he really got apnic (stopped breathing) and was not rousable, they’d intubate - put in a breathing tube. Since that didn’t happen, it means he wasn’t in grave danger, but she needed to make sure he’d wake up fairly frequently.
WhyNot,
who spent a LOT of time slapping a preemie’s feet and rubbing her sternum to wake her up to breathe again, 'though she wasn’t on morphine.
The MS was likely given to stave off post-op pain. The reason the nurse kept telling you to breathe was because you were still recovering from anesthesia. That’s why we call it Recovery.
Most anesthesia is much more respiratory depressing than morphine. The two in combination will increase that depression, however, pain control is important.
The ratio of nurses to patients in recovery is very low, usually 1 nurse to 2 patients. Even if you weren’t aware of her being close by, in all likelihood you were always with line-of-sight of a nurse.
I think you mean “patients to nurses”.
I hate being one of those people that asks this, but could I have a cite on that death total please? That number seems rather large; that’s 534 a day - four times the rate of automobile deaths.
Sorry, I’ve always had trouble with that. These <> flumox me too. :rolleyes:
WhyNot is going to cite the NIH study from several years ago which was severely flawed in it’s methods. But it made for a good news story.
Thank You. When I told my doctor he was pretty non committal and I wanted to know if it was something I needed to worry about and mention in the future.
Are people ever given morphine in a situation where they aren’t being monitored by machines or an actual person?
Right you are. WhyNot googled hospital error deaths annual and grabbed the first number that had a bunch of hits without analyzing the reports deeply. I would like to know more about the flaws, though, as none of the hits on the first few pages were for anything mentioning flaws.
But sure, half that number. Quarter it even. It’s still a whole lot of people dead due to hospital error every year. Far too many to relax your vigilance under the notion that hospitals surely wouldn’t make mistakes that could cost you your life.
Sure. Mr. singular and I have both been prescribed morphine in pursuit of cheap pain relief. I didn’t last on it, though. I have a high tolerance for side effects, but morphine is the only drug that ever left me in danger of nodding off at work. Post-op it’s great, but not so much for day-to-day functioning.
Actually, if someone stopped breathing they should get Narcan (naloxone) before anyone were to attempt intubation.
The problem with Narcan is that it’s often “overdosed” to the point that the pain comes back in full force or worse leaving a patient in worse agony than when he/she started.
When I was in the Navy, one of my instructors had surgery to reattach an esophagus that was threatening to tear loose. The surgeons laid him open from the clavicular notch to navel and sawed his sternum in two to get at things. Needless to say, he was on morphine for several weeks afterward and in the hospital for several weeks more until they were sure everything would stay in place when he stood up.
Anyhow, afterwards he said two things about morphine. First, it really screws up your time sense. He’d be asked what he wanted for lunch, think about it for a bit, then answer – to a completely different corpsman, because it was ten hours later.
Second, he said he’d always wondered why someone would get started on heroin. Addiction he could understand, but why would anyone in their right mind, after observing junkies around them, start the habit in the first place. Insight came with personal experience. “You know,” he said. “If your world’s shit, and you haven’t anything to do, it’s a really pleasant way to pass the day.”
Well sure, but that wasn’t my point.
you have to know how to titrate narcan, something a lot of rookies learn the hard way
Another thing to point out is that people who’ve been on MS for a while build a tolerance.
I cared for a man with sickle cell anemia, who would come in to the hospital in crisis.
Because we knew his tolerance, we’d start him at 40 mg/hour (normal dose for severe pain is 10 mg/ 3-4 hours). Over the course of a week, he’d go up to 100 mg/hour. When his crisis was over, he’d pull out his IV and leave. The lowest his respiratory rate ever went was 8.
This was before naloxone (Narcan) existed, so intubation was the only option for respiratory failure. He didn’t require intubation until his final crisis, but not because of morphine. His disease killed off his lung tissue.
Some of the resident doctors thought he must be using outside the hospital. I knew him outside the hospital, I knew his wife and his kids. He never used anything stronger than tylenol when he wasn’t in crisis.
This is purely anecdotal, but it seems that as long as a patient has significant pain, there’s less respiratory depression from opiates. Once the reason for the pain is removed, respiratory drive drops.
An example is a chest tube, used to re-expand a lung. It hurts the whole time it’s in. Once it’s taken out, the pain is gone. I’ve found that if the patient was medicated shortly before pulling the tube, there’s a greater chance of respiratory depression right after.
I’ve heard anecdotal reports of precisely that (that pain keeps the respiratory drive up when you’re on opiates, and it drops when the pain goes away) from … well, I don’t have the computer with my notes handy at the moment, but it’s something I’ve heard from easily more than a dozen people.