Medizinische Klinik

, Volume 92, Issue 5, pp 296–299 | Cite as

Myoklonien als Folge von hochdosierter epiduraler und intravenöser Morphininfusion

  • Lukas Radbruch
  • Detlev Zech
  • Stephan Grond


□ Hintergrund

Myoklonien sind eine mögliche Nebenwirkung einer Opioidtherapie, und sind swohl nach systemischer wie nach rückenmarksnaher Applikation beschrieben worden.

□ Falldarstellung

Berichtet wird der Fall einer Patientin mit metastasiertem Rektumkarzinom, die als Folge einer hochdosierten epiduralen und kombiniert intravenösen Morphininfusion ausgeprägte Myoklonien entwickelte. Diese Komplikation trat bei maximalen Tagesdosierungen von epidural 300 mg und intravenös 80 mg auf und verschwand vollständig nach Dosisreduktion. Behandlungsversuche werden dargestellt, die Pathophysiologie der Myoklonien wird diskutiert.

□ Schlußfolgerung

Zur Behandlung opioidinduzierter Myoklonien sollte neben der symptomatischen Therapie mit Benzodiazepinen oder Baclofen ein Wechsel oder eine Dosisreduktion des Opioids erwogen werden.

Myoclonus following high dose epidural and intravenous infusion of morphine


□ Background

Myocloni are a possible side effect of opioid therapy, and have been described following systemic as well as spinal application.

□ Case Report

We report the case of a patient with metastatic carcinoma of the rectum who developed myoclonus following administration of high-dose epidural combined with iv morphine. This complication occured with maximum daily doses of 300 mg epidurally and 80 mg intravenously and disappeared completely after dose reduction. Treatment trials are presented, the pathophysiology of the myoclonus is discussed.

□ Conclusion

For treatment of opioid-induced myoclonus a dose reduction or a change of the opioid should be considered as well as symptomatic treatment with benzodiazepines or baclofen.


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Copyright information

© Urban & Vogel 1997

Authors and Affiliations

  • Lukas Radbruch
    • 1
  • Detlev Zech
  • Stephan Grond
    • 1
  1. 1.Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin der UniversitätKöln

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