Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
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BACKGROUND: Data on the frequency of priapism after spinal injections is lacking. Priapism may occur as a rare complication following intrathecal narcotic administration. This report describes an uncommon adverse reaction to intrathecal morphine injection uniquely without concurrent local anesthetic.
CASE REPORT: A 74-year-old male presented to the pain management office for a scheduled intrathecal bolus trial to monitor for response prior to permanent placement of an intrathecal pump. Following an intrathecal injection of a bolus dose of 100 mcg of morphine, the patient noted the development of an erection lasting 8 hours. A diagnosis of intrathecal morphine-induced priapism was made.
CONCLUSION: This report presents the first case in the literature of priapism induced by noncontinuous intrathecal morphine injection in the context of an intrathecal pump trial. A specific mechanism has not yet been defined; however, we believe multiple factors play a role in the body’s response to morphine.
KEY WORDS: Case report, chronic pain, intrathecal drug delivery, morphine, priapism
