Excessive sweating following intrathecal μ agonists: Effective atropine management

Many thermal distortions may accompany the profound extended analgesia of intrathecal μ agonists. Hypothermia is the commonest, but a syndrome including a profuse sweating was also reported. Conservative management for this sweating extends patient suffering more than 6 h. Other treatment options showed variable success rates. In a case series, atropine sulfate showed effective sweat suppression following intrathecal morphine 0.3 mg or fentanyl 25 mcg. Treatment options and possible mechanisms of sweating are reviewed in relation to opioids, regional block and general patient factors.