Is morphine recommended for abdominal pain after undergoing gastric bypass?
Patient: My 130 lb mother was given 4 mg of morphine at 0630 and another 4 mg at 0930. Unbeknownst to us, LTAC has been giving her 4 mg of morphine as needed. Last night she complained of her stomach being on fire She is being fed through an NG tube that goes into her duodenum (she had a gastric bypass). After they reversed morphine overdose with Narcan and dopamine (BP dropped like a stone), she till complained of abdominal pain. Took her for catscan which revealed blood in abdomen and in pancreas. What could cause this? She is in LTAC recovering from lobectomy (she had a trach and they are weaning her from vent which was going quite well until this episode). Doctor: There's no contraindication for giving a gastric bypass patient morphine. However, she might have been given overdose given that-Her BP dropped (morphine can drop BP)-she needed Narcan to reverse Morphine's effectThe BP drop could have been due to Morphine, loss of blood (as blood is seen in and on CT scan)It seems like the Morphine and blood in abdomen are unrelated events.If I were a doctor treating her I'd like to know the following:- when was the bypass surgery- is she currently on any anticoagulantsTake her back to the surgeon who performed her bypass or at least, her lobectomy for evaluation.Hope this helps.