Spouse-Controlled Analgesia

A 40-year-old healthy registered nurse received patient-controlled analgesia (PCA) following lumbar laminectomy. The Abbot life Care CPA system used was set to deliver 2 mg doses of morphine with a lockout interval of 10 min. The patient was dissatisfied with the result, and she and her husband decided on a remedy. He would continue to push the button on the PCA device after every lockout interval. This spouse-activated method was continued for about 4 hours before being discovered when the women was sleepy but arousable with a respiratory rate of 18/min, HR of 106 beats/min. and BP of 108/70 mmHg. Health care workers should be aware that some patients in concert with their “significant others” may attempt to achieve higher drug blood levels.