BACKGROUND AND OBJECTIVES: Pruritus induced by intrathecal morphine is a concern in many obstetric patients after cesarean delivery and may detract from the benefit of postoperative pain relief. This study was performed to investigate the efficacy of ondansetron (5-HT3 receptor antagonist) in treatment of pruritus following intrathecal morphine. METHODS:Eighty parturients developing moderate to severe pruritus followingintrathecal morphine were randomly allocated into 2 groups. One group received 4 mg ondansetron while the other group received placebo (normal saline). The improvement of pruritus and other adverse effects such as pain scores, nausea, vomiting, sedation, hallucination, and respiratory depression were determined at 30 minutes after study drugs' administration. RESULTS: The treatment success rate was higher in the ondansetron group than in the placebo group (80% v 36%, P < .001). Among the successfully treated patients, the recurrence rates of moderate to severe pruritus within 4 hours after administration of ondansetron and placebo were 12% and 70%, respectively (P < .001). The number of patients with decreased nausea and vomiting score was also higher in the ondansetron group (11 v 1, P < .006). CONCLUSION:Ondansetron treats intrathecal morphine-induced pruritus after cesarean delivery, particularly in patients suffering from both nausea/vomiting and pruritus.
RCT Entities:
BACKGROUND AND OBJECTIVES:Pruritus induced by intrathecal morphine is a concern in many obstetricpatients after cesarean delivery and may detract from the benefit of postoperative pain relief. This study was performed to investigate the efficacy of ondansetron (5-HT3 receptor antagonist) in treatment of pruritus following intrathecal morphine. METHODS: Eighty parturients developing moderate to severe pruritus following intrathecal morphine were randomly allocated into 2 groups. One group received 4 mg ondansetron while the other group received placebo (normal saline). The improvement of pruritus and other adverse effects such as pain scores, nausea, vomiting, sedation, hallucination, and respiratory depression were determined at 30 minutes after study drugs' administration. RESULTS: The treatment success rate was higher in the ondansetron group than in the placebo group (80% v 36%, P < .001). Among the successfully treated patients, the recurrence rates of moderate to severe pruritus within 4 hours after administration of ondansetron and placebo were 12% and 70%, respectively (P < .001). The number of patients with decreased nausea and vomiting score was also higher in the ondansetron group (11 v 1, P < .006). CONCLUSION:Ondansetron treats intrathecal morphine-induced pruritus after cesarean delivery, particularly in patients suffering from both nausea/vomiting and pruritus.
Authors: Andrea C Tricco; Charlene Soobiah; Erik Blondal; Areti A Veroniki; Paul A Khan; Afshin Vafaei; John Ivory; Lisa Strifler; Huda Ashoor; Heather MacDonald; Emily Reynen; Reid Robson; Joanne Ho; Carmen Ng; Jesmin Antony; Kelly Mrklas; Brian Hutton; Brenda R Hemmelgarn; David Moher; Sharon E Straus Journal: BMC Med Date: 2015-06-18 Impact factor: 8.775