Prophylactic Ondansetron for Prevent of Intrathecal Morphine Induced Pruritus after Cesarean Delivery
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Abstract
Background : The intrathecal morphine is highly effective in providing analgesia for postoperative pain management, pruritus is a common side effect. Its incidence is especially high in patients undergoing cesarean delivery.
Objective: This study was performed to investigate the efficacy of ondansetron in preventing pruritus following intrathecal morphine in patient undergoing cesarean delivery.
Methods: In a prospective, double-blinded, randomized study, ninety parturients undergoing cesarean delivery with spinal anesthesia were studied. All patients received 0.5% hyperbaric bupivacaine 2 ml and intrathecal morphine 0.2 mg. After a child birth, the patients were randomized into three groups. Group 1 received normal saline (placebo group), group 2 received ondansetron 4 mg intravenously (0-4 group), and group 3 received ondansetron 8 mg intravenously (0-8 group). Patients were evaluated for severity of pruritus and nausea/vomiting at 2 and 24 hr. postoperatively.
Statistical analysis: ANOVA, Kruskal-Wallis’s, and Mann-Whitney U-test
Results: 2 hr postoperatively, the incidence of pruritus was significantly lower in ondansetron group 4 and 8 mg group when compared with the placebo group (46.7%, 30%, and 60% respectively, p<0.05). At 24 hr, ondansetron 4 and 8 mg group less frequent in pruritus when compared with placebo group (13.3%, 6.7%, and 40% respectively, p<0.05). The postoperative nausea/vomiting at 24 hr were not significant different.
Conclusion: Prophylactic ondansetron prevents intrathecal morphine induced pruritus after cesarean delivery, particularly in patients suffering from both pruritus and nausea/vomiting.
Key words: ondansetron, intrathecal morphine, pruritus
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References
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