Abstract
We describe two patients who developed profound sedation and unconsciousness during continuous administration of morphine through an epidural catheter. Both patients underwent abdominal surgery under combined epidural and general anesthesia. There were no symptoms or signs suggestive of subarachnoid migration of the epidural catheter during surgery. Clear fluid, which contained sugar, was aspirated through the epidural catheter, when profound sedation was noted. Their SpO2 did not decrease to abnormal levels while breathing oxygen-enriched air. Continuous intravenous administration of naloxone improved profound sedation and respiratory depression. Subarachnoid migration of an epidural catheter should be considered as a differential diagnosis of unusual profound sedation during epidural administration of opioids.
