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View Full Version : Morphine Used as General Anesthetic



noizu
01-18-2015, 02:55 PM
I just had a few questions about the use of morphine as a sedative. The patient is a 12 year old boy of approximately 70 pounds-- so I can't imagine it would take a lot of morphine to do the job. If he is given an intravenous injection to the neck with morphine (for an operation), about how long would it take for him to actually fall unconscious? From what I've researched on the subject, morphine is a bit slower to knock out patients than other drugs typically used for general anesthetic, but the actual passing out part is pretty instantaneous. Just wanted to confirm. Additionally, I'm also curious about how waking up from such a thing would be. MC is not on an IV drip of morphine, nor is he in a hospital setting where such a thing would be available. If he's out for 2-4 hours and in such a situation, would the morphine wear off just enough for him to wake up but still have the analgesic effects of the morphine, or would he wake up and be in pain?

Pyekett
01-18-2015, 03:04 PM
Would you consider a different agent such as ketamine, or is it definitely morphine?

noizu
01-18-2015, 03:16 PM
It's definitely morphine.

mirandashell
01-18-2015, 07:24 PM
Is it in a battle situation? It's field medicine?

noizu
01-18-2015, 11:50 PM
Not exactly. MC is a prisoner who is injured and left in his cell before he is quickly discovered by someone with medical knowledge and treats MC. The person that helps him is something of a double agent-- he's on the enemy's side, but is also a prisoner-- he's just given more freedoms and isn't kept in a cell because he serves as the big bad's medic. His injury is one of a slashed Achilles tendon-- something that's not immediately fatal but could be due to blood loss and infection, and MC is definitely in a setting where these things are possible. So, no. There isn't immediate danger to MC at the moment, he's simply in his cell. When he wakes up, he is still in the cell.

bellabar
01-19-2015, 05:02 AM
He is most definitely is in immediate danger if someone is planning on attempting to give him a general anaesthetic with morphine injected via a neck vein.
Pyekett gave you a good suggestion, go look up ketamine instead. It would be much more likely in an out of hospital situation. And why the neck?Hands and elbows also have very good veins for giving drugs.

MDSchafer
01-19-2015, 05:46 AM
Not exactly. MC is a prisoner who is injured and left in his cell before he is quickly discovered by someone with medical knowledge and treats MC. The person that helps him is something of a double agent-- he's on the enemy's side, but is also a prisoner-- he's just given more freedoms and isn't kept in a cell because he serves as the big bad's medic. His injury is one of a slashed Achilles tendon-- something that's not immediately fatal but could be due to blood loss and infection, and MC is definitely in a setting where these things are possible. So, no. There isn't immediate danger to MC at the moment, he's simply in his cell. When he wakes up, he is still in the cell.

Repairing an Achilles tendon, depending on how clean the cut was, could be a doable field operation for someone with a lot of experience. It's not easy, and it needs to be immobilized for two to three weeks and then followed up with a lot of PT.

I would not use Morphine to knock out a kid. One of Morphine's effects is respiratory depression, and the higher the dose the higher the chance of that. If the kid's already lost a good bit of blood Morphine could send the kid into shock. I'd be so worried about using Morphine on a 12-year-old I'd rather just give him a stick to bite down on. The Achilles isn't loaded down with nerves, so it would hurt, but put the kid on his belly so he can't see it, numb the area with ice, or preferably a local anesthetic, and then do the cutting and stitching.

Pentobarbital and other benzos are fairly common street drugs that's probably as easy or easier to come across in prisons and whatnot. I would try to use a benzo before I'd use morphine. Hell, save the morphine and use it for post surgical pain control..

I found a fairly bloody picture of what happens if you want to check out what an Achilles rupture repair looks like. Fair warning it is not for the faint of heart, or if you have an aversion to medical procedures.
http://www.aofas.org/footcaremd/treatments/PublishingImages/Image_Bevoni_Achilles_rupture_3_YPC.png

Rufus Coppertop
01-19-2015, 11:29 AM
Morphine is NOT a general anaesthetic.

Giving someone enough morphine to render them unconscious is pretty much equivalent to giving them a heroin overdose.

And giving it in the neck? Why?

Orianna2000
01-19-2015, 08:07 PM
I'll share my experience with waking up after surgery, since you asked about that. I had my gallbladder removed a few months ago, and I also had my appendix out when I was a kid. Both surgeries were similar, although with the first one, we didn't realize that intravenous morphine is totally ineffective on me, so I woke up screaming. They actually had to bring my parents into the recovery room, which is normally against the rules, because they thought they could calm me down a little. (Apparently, my screaming was disturbing the other patients. . . .) The doctor said they gave me enough morphine to knock out a small horse, and I was still screaming. Somehow, it didn't occur to them to try something other than morphine!

A few years ago, I was given morphine for pleurisy, and again, it did nothing, so I finally figured out that, for some reason, IV morphine just doesn't work on me.

With the gallbladder surgery, I woke up slowly, gradually. At first, I couldn't see. I don't know if my eyes were closed and I just couldn't figure out how to open them, or if the anesthesia temporarily blinded me. I wasn't afraid, but I was in a lot of pain. I could hear the nurses talking around me. I was probably whimpering with pain, because it HURT. Someone asked how much pain I was in, on a scale from one to ten, and I said, "Nine and a half." They asked where the pain was, and I told them, "My belly button." (That's where the biggest incision was.) They gave me more pain medicine (not morphine!) and I drifted off, waking a little while later when the doctor came in and the nurse reported on my status. It took maybe an hour before I was able to open my eyes, right around the time they finally let my husband in to see me. I might have kept my eyes closed because the lights were so bright, but I don't know for sure.

I was definitely very groggy, and in a whole lot of pain. Because they couldn't give me morphine, they gave me dilaudid, which in the past, made me hallucinate. Fortunately, it didn't this time.

blacbird
01-20-2015, 12:00 PM
Morphine is NOT a general anaesthetic.

Beat me to it. Morphine is a sedative/pain reducer, still commonly used in hospitals and military field situations. My one experience with it was with an emergency appendectomy nine years ago. It was administered, slowly and continuously, via IV, after the surgery. It was . . . nice. Helpful. But anaesthetics are different animals.

caw

Dave Williams
01-21-2015, 03:52 PM
I've had surgery with a combination of morphine and pentothal on several occasions. I didn't see that it was any slower than Demerol as far as going under.

Waking up was slow and bleary, I had severe nausea and vertigo for most of a day. *Way* better than Demerol, where my reaction is much worse.

Plain old Valium, on the other hand, is like flicking a light swich off and then back on. I've had orthopedic surgery with the stuff. Wake up, sit up, "Can I go home now? Why not?"

Maze Runner
01-21-2015, 10:24 PM
Had a cystoscopy twice as a kid. I'm pretty sure morphine was used both times, in multiple doses. At first I got very high, "nice" is right. Then the next shot put me out. Not a 12 yr old, 70 lb kid, but a 15 yr old, 130 lb kid, who woke up right before they yanked it out. Ohhhhhhh...The second time I told them repeatedly to please, please, up the dosage.