Intrathecal bupivacaine and morphine toxicity leading to transient hypotension and delayed status epilepticus

We appreciate the thoughtful and constructive feedback submitted. We certainly acknowledge the potential contribution of morphine to the clinical presentation of our patient [1-4], but the responsibility of any one drug to the presentation is largely unknowable without data on the toxicity of intrathecal bupivacaine. Excessive CNS delivery of each drug could logically be anticipated to cause deleterious effects. It would be overly dismissive to exclude bupivacaine's potential contribution. First, bupivacaine was administered in an overdose of equal proportion relative to its therapeutic spinal dose as morphine.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research