{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T10:43:03Z","timestamp":1761648183169},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,7,15]],"date-time":"2014-07-15T00:00:00Z","timestamp":1405382400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Vet Emergen Crit Care"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe general anesthesia and successful treatment of an alpaca, which developed respiratory arrest 2 hours after intrathecal injection of morphine and bupivacaine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Summary<\/jats:title><jats:p>A 10\u2010day\u2010old female alpaca weighing 7.3 kg was presented to our hospital with a fractured right tibia. The cria was anesthetized to repair the fracture with a dynamic compression plate. Anesthesia was induced with IV propofol and maintained with sevoflurane in 100% oxygen. Prior to the start of surgery the alpaca received an unintended intrathecal injection of 0.6 mL of a solution of 0.5 mg morphine (0.068 mg\/kg) and 1.5 mg bupivacaine (0.2 mg\/kg), after an attempted lumbo\u2010sacral epidural. The alpaca developed respiratory arrest 120 minutes after the intrathecal injection was administered. Adequate hemoglobin\u2010oxygen saturation was maintained despite minimal intermittent manual ventilation, but marked hypercapnia developed (PaCO<jats:sub>2<\/jats:sub>of 17.3 KPa [130 mm Hg]). Delayed respiratory depression resulting from cephalad migration of intrathecal morphine was suspected. Ventilation was supported until the end of surgery when sevoflurane was discontinued. The trachea remained intubated, 100% oxygen was supplied, and ventilation was supported at 2\u20134 breaths\/min for the next 60 minutes, but no attempts to breathe spontaneously were detected. Intravenous naloxone (0.3 mg [0.04 mg\/kg]) was administered slowly to effect until adequate spontaneous ventilation and full consciousness returned. The anesthetic recovery of the alpaca was rapid and uneventful after the opioid antagonist was given.<\/jats:p><\/jats:sec><jats:sec><jats:title>New Information Provided<\/jats:title><jats:p>Delayed respiratory depression is a potential complication after intrathecal administration of morphine. Careful dose\u2010adjustment may reduce the risk, and close monitoring will result in early detection and treatment of this complication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vec.12198","type":"journal-article","created":{"date-parts":[[2014,7,15]],"date-time":"2014-07-15T20:12:17Z","timestamp":1405455137000},"page":"450-454","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Possible delayed respiratory depression following intrathecal injection of morphine and bupivacaine in an alpaca"],"prefix":"10.1111","volume":"24","author":[{"given":"Miguel Mart\u00ednez","family":"LdoVet","sequence":"first","affiliation":[{"name":"School of Veterinary Sciences University of Bristol Langford House Bristol BS40 5DU United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela J.","family":"Murison","sequence":"additional","affiliation":[{"name":"School of Veterinary Sciences University of Bristol Langford House Bristol BS40 5DU United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo","family":"Murrell","sequence":"additional","affiliation":[{"name":"School of Veterinary Sciences University of Bristol Langford House Bristol BS40 5DU United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,7,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","unstructured":"CampoyL.Epidural and spinal anesthesia in the dog. 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