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Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron.
Int J Obstet Anesth. 2010 Jan; 19(1):56-60.IJ

Abstract

BACKGROUND

The incidence of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine may be 60-100%, and is a common cause of maternal dissatisfaction. Ondansetron has been shown to reduce pruritus but the effect is short-lived. The objective of this randomized double-blind trial was to evaluate the anti-pruritic efficacy of granisetron compared with ondansetron.

METHODS

Eighty ASA I or II women undergoing elective caesarean section received spinal anaesthesia with 0.5% hyperbaric bupivacaine 10 mg, fentanyl 25 microg and preservative-free morphine 150 microg. After delivery of the baby and clamping of the umbilical cord, they were randomised to receive granisetron 3mg i.v. (group G) or ondansetron 8 mg i.v. (group O).

RESULTS

The two groups were similar for age, gestational age, height and weight. According to visual analogue pruritus scores, patients in group G experienced less pruritus at 8h (P=0.003) and 24h (P=0.01). Fewer patients in group G (n=8) than group O (n=18) required rescue anti-pruritic medication (P=0.03). Satisfaction scores were also higher in group G than in group O (P=0.03). There was no difference in overall incidence of pruritus, nausea and vomiting, and visual analogue pain scores between the two groups.

CONCLUSIONS

Administration of granisetron 3mg i.v. reduces the severity of pruritus and the use of rescue anti-pruritic medication, and improves satisfaction but does not reduce the overall incidence of pruritus in women who have received subarachnoid morphine 150 microg compared to ondansetron 8 mg i.v.

Authors+Show Affiliations

Department of Anaesthesia and Perioperative Medicine, Coombe Women and Infants University Hospital, Dublin, Ireland. tutan@me.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19945275

Citation

Tan, T, et al. "Reduction of Severity of Pruritus After Elective Caesarean Section Under Spinal Anaesthesia With Subarachnoid Morphine: a Randomised Comparison of Prophylactic Granisetron and Ondansetron." International Journal of Obstetric Anesthesia, vol. 19, no. 1, 2010, pp. 56-60.
Tan T, Ojo R, Immani S, et al. Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron. Int J Obstet Anesth. 2010;19(1):56-60.
Tan, T., Ojo, R., Immani, S., Choroszczak, P., & Carey, M. (2010). Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron. International Journal of Obstetric Anesthesia, 19(1), 56-60. https://doi.org/10.1016/j.ijoa.2009.05.005
Tan T, et al. Reduction of Severity of Pruritus After Elective Caesarean Section Under Spinal Anaesthesia With Subarachnoid Morphine: a Randomised Comparison of Prophylactic Granisetron and Ondansetron. Int J Obstet Anesth. 2010;19(1):56-60. PubMed PMID: 19945275.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron. AU - Tan,T, AU - Ojo,R, AU - Immani,S, AU - Choroszczak,P, AU - Carey,M, Y1 - 2009/11/27/ PY - 2008/11/28/received PY - 2009/03/09/revised PY - 2009/05/18/accepted PY - 2009/12/1/entrez PY - 2009/12/1/pubmed PY - 2010/3/26/medline SP - 56 EP - 60 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 19 IS - 1 N2 - BACKGROUND: The incidence of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine may be 60-100%, and is a common cause of maternal dissatisfaction. Ondansetron has been shown to reduce pruritus but the effect is short-lived. The objective of this randomized double-blind trial was to evaluate the anti-pruritic efficacy of granisetron compared with ondansetron. METHODS: Eighty ASA I or II women undergoing elective caesarean section received spinal anaesthesia with 0.5% hyperbaric bupivacaine 10 mg, fentanyl 25 microg and preservative-free morphine 150 microg. After delivery of the baby and clamping of the umbilical cord, they were randomised to receive granisetron 3mg i.v. (group G) or ondansetron 8 mg i.v. (group O). RESULTS: The two groups were similar for age, gestational age, height and weight. According to visual analogue pruritus scores, patients in group G experienced less pruritus at 8h (P=0.003) and 24h (P=0.01). Fewer patients in group G (n=8) than group O (n=18) required rescue anti-pruritic medication (P=0.03). Satisfaction scores were also higher in group G than in group O (P=0.03). There was no difference in overall incidence of pruritus, nausea and vomiting, and visual analogue pain scores between the two groups. CONCLUSIONS: Administration of granisetron 3mg i.v. reduces the severity of pruritus and the use of rescue anti-pruritic medication, and improves satisfaction but does not reduce the overall incidence of pruritus in women who have received subarachnoid morphine 150 microg compared to ondansetron 8 mg i.v. SN - 1532-3374 UR - https://www.unboundmedicine.com/medline/citation/19945275/Reduction_of_severity_of_pruritus_after_elective_caesarean_section_under_spinal_anaesthesia_with_subarachnoid_morphine:_a_randomised_comparison_of_prophylactic_granisetron_and_ondansetron_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(09)00119-8 DB - PRIME DP - Unbound Medicine ER -