Morphine poisoning in a patient with malignant peritoneal mesothelioma: A case report

Zhao,Chenguang; Bai,Jing; Jia,Sicong; Zhang,Xin; Geng,Dandan; Li,Dapeng; Wang,Yingnan; Gao,Shasha; Zhang,Fengbin; Liu,Xiaoyan

doi:10.3892/etm.2023.11896

Morphine poisoning in a patient with malignant peritoneal mesothelioma: A case report

Authors:
- Chenguang Zhao
- Jing Bai
- Sicong Jia
- Xin Zhang
- Dandan Geng
- Dapeng Li
- Yingnan Wang
- Shasha Gao
- Fengbin Zhang
- Xiaoyan Liu
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Affiliations: Department of Gastroenterology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China, Department of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, P.R. China, Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China, Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050000, P.R. China, Department of Gastrointestinal Oncology, Qinhuangdao Fourth Hospital, Qinhuangdao, Hebei 066000, P.R. China, Department of Pediatrics, Traditional Chinese Medical Hospital of Hebei Province, Shijiazhuang, Hebei 050000, P.R. China
Published online on: March 17, 2023 https://doi.org/10.3892/etm.2023.11896
Article Number: 197
Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Pain is one of the most common symptoms of malignant peritoneal mesothelioma. Therefore, analgesia serves an indispensable role in the treatment of this condition. Morphine is a representative opioid, which is widely used in clinical practice; however, excessive or unreasonable application can cause poisoning. Few cases of morphine poisoning have been reported, and cases of morphine poisoning in patients with malignant peritoneal mesothelioma are even more rare. Here, we present a case of morphine poisoning in a patient with malignant peritoneal mesothelioma. The patient had a high abdominal tumor load, hepatorenal insufficiency, and was treated with a combination of morphine and the sedative benzodiazepine, eventually leading to morphine poisoning. Therefore, for cancer pain, omni‑directional and whole‑process management should be emphasized. In patients with hepatorenal insufficiency, those treated with morphine combined with benzodiazepines, or those with a high abdominal tumor load, attention should be paid to drug absorption, excretion and interaction, and the drug dose during administration should be reduced to avoid drug poisoning. If poisoning symptoms occur, timely measures should be taken to reduce poison absorption and increase poison excretion, and antagonists should be used to reverse the poisoning and reduce the damage caused.

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