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Prophylactic intravenous ondansetron and dolasetron in intrathecal morphine-induced pruritus: a randomized, double-blinded, placebo-controlled study.
Anesth Analg. 2005 Nov; 101(5):1516-20.A&A

Abstract

Pruritus is the most common side effect of intrathecal morphine for postoperative pain relief. Activation of central 5-hydroxytryptamine subtype 3 (5-HT3) receptors is one of its possible mechanisms. The role of 5-HT3 antagonists in the prevention of pruritus has not been clearly established. In a prospective, randomized, double-blind, placebo-controlled study, we evaluated the efficacy of prophylactic administration of ondansetron and dolasetron for the prevention of intrathecal morphine-induced pruritus. The patients were randomized into 3 groups to receive either 4 mg ondansetron IV (group O, n = 35), 12.5 mg dolasetron IV (group D, n = 35) or 5 mL placebo (group P, n = 35) 30 min before administration of spinal anesthesia with 10 to 17.5 mg of 0.5% hyperbaric bupivacaine and 0.25 mg of morphine for urologic, orthopedic, or vascular surgery. Patients were evaluated for incidence and severity of pruritus at arrival to the postanesthesia care unit and at 2, 4, 8, and 24 h postoperatively. The incidence and severity of pruritus was significantly less frequent in the ondansetron and dolasetron groups compared with placebo (34%, 20%, and 66% respectively, P < 0.01). Patients who received 5-HT3 antagonist reported significantly less total severity of pruritus compared with placebo during the first 8 h and the severe pruritus was observed only in patients within P group (P group: 4 of 35; 11%, O or D group: 0 of 35; 0%, P < 0.05). We conclude that the prophylactic use of ondansetron and dolasetron helps to reduce the incidence and severity of intrathecal morphine-induced pruritus.

Authors+Show Affiliations

University Hospital of Alexandroupolis, Level 2, Room: 54.10, Dragana, Alexandroupolis 68100, Greece. christosdr@panafonet.grNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16244023

Citation

Iatrou, Christos A., et al. "Prophylactic Intravenous Ondansetron and Dolasetron in Intrathecal Morphine-induced Pruritus: a Randomized, Double-blinded, Placebo-controlled Study." Anesthesia and Analgesia, vol. 101, no. 5, 2005, pp. 1516-20.
Iatrou CA, Dragoumanis CK, Vogiatzaki TD, et al. Prophylactic intravenous ondansetron and dolasetron in intrathecal morphine-induced pruritus: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 2005;101(5):1516-20.
Iatrou, C. A., Dragoumanis, C. K., Vogiatzaki, T. D., Vretzakis, G. I., Simopoulos, C. E., & Dimitriou, V. K. (2005). Prophylactic intravenous ondansetron and dolasetron in intrathecal morphine-induced pruritus: a randomized, double-blinded, placebo-controlled study. Anesthesia and Analgesia, 101(5), 1516-20.
Iatrou CA, et al. Prophylactic Intravenous Ondansetron and Dolasetron in Intrathecal Morphine-induced Pruritus: a Randomized, Double-blinded, Placebo-controlled Study. Anesth Analg. 2005;101(5):1516-20. PubMed PMID: 16244023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic intravenous ondansetron and dolasetron in intrathecal morphine-induced pruritus: a randomized, double-blinded, placebo-controlled study. AU - Iatrou,Christos A, AU - Dragoumanis,Christos K, AU - Vogiatzaki,Theodosia D, AU - Vretzakis,George I, AU - Simopoulos,Constantinos E, AU - Dimitriou,Vasilios K, PY - 2005/10/26/pubmed PY - 2005/12/13/medline PY - 2005/10/26/entrez SP - 1516 EP - 20 JF - Anesthesia and analgesia JO - Anesth Analg VL - 101 IS - 5 N2 - Pruritus is the most common side effect of intrathecal morphine for postoperative pain relief. Activation of central 5-hydroxytryptamine subtype 3 (5-HT3) receptors is one of its possible mechanisms. The role of 5-HT3 antagonists in the prevention of pruritus has not been clearly established. In a prospective, randomized, double-blind, placebo-controlled study, we evaluated the efficacy of prophylactic administration of ondansetron and dolasetron for the prevention of intrathecal morphine-induced pruritus. The patients were randomized into 3 groups to receive either 4 mg ondansetron IV (group O, n = 35), 12.5 mg dolasetron IV (group D, n = 35) or 5 mL placebo (group P, n = 35) 30 min before administration of spinal anesthesia with 10 to 17.5 mg of 0.5% hyperbaric bupivacaine and 0.25 mg of morphine for urologic, orthopedic, or vascular surgery. Patients were evaluated for incidence and severity of pruritus at arrival to the postanesthesia care unit and at 2, 4, 8, and 24 h postoperatively. The incidence and severity of pruritus was significantly less frequent in the ondansetron and dolasetron groups compared with placebo (34%, 20%, and 66% respectively, P < 0.01). Patients who received 5-HT3 antagonist reported significantly less total severity of pruritus compared with placebo during the first 8 h and the severe pruritus was observed only in patients within P group (P group: 4 of 35; 11%, O or D group: 0 of 35; 0%, P < 0.05). We conclude that the prophylactic use of ondansetron and dolasetron helps to reduce the incidence and severity of intrathecal morphine-induced pruritus. SN - 0003-2999 UR - https://www.unboundmedicine.com/medline/citation/16244023/Prophylactic_intravenous_ondansetron_and_dolasetron_in_intrathecal_morphine_induced_pruritus:_a_randomized_double_blinded_placebo_controlled_study_ L2 - https://doi.org/10.1213/01.ANE.0000181338.35454.6A DB - PRIME DP - Unbound Medicine ER -