Tags

Type your tag names separated by a space and hit enter

Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section.
BMC Anesthesiol. 2015 Feb 17; 15:18.BA

Abstract

BACKGROUND

Intrathecal morphine is commonly used for post caesarean analgesia. However, their use is frequently associated with the incidence of troublesome side effects such as nausea, vomiting and pruritus. Various mechanisms have been postulated for the opioid-induced pruritus, with a variety of medications with different mechanisms of actions formulated for the prevention and treatment. But, the results are inconsistent and hence the prevention and treatment of opioid-induced pruritus still remains a challenge. Ondansetron which is antiemetic, non-sedative and has no antianalgesic effect is an antagonist to 5-HT3 receptor, the receptor with which opioids interacts and imparts its effects. Ondansetron, thus, would be an attractive treatment strategy for both opioid-induced pruritus and post-operative nausea and vomiting.

METHODS

After the approval from institutional review committee and written consent received from the patient, 50 healthy parturients of ASA I and II physical status undergoing caesarean section under spinal anaesthesia were enrolled for the study. They were randomly categorized into placebo group (2 ml normal saline) and treatment group (2 ml of 4 mg ondansetron), each group containing 25 patients. Pruritus and post-operative nausea and vomiting scores were recorded up to 24 hours after the administration of intrathecal morphine. Statistical analysis was performed using chi-square test.

RESULTS

The incidence, severity and necessity of treatment for pruritus in the treatment group was significantly reduced compared to the placebo group (16% vs 88%). Similarly, the risk of post-operative nausea and vomiting in the treatment group was less compared to the placebo group (8% vs 56%).

CONCLUSION

Prophylactic administration of ondansetron to parturients receiving intrathecal morphine for post-operative analgesia provides a significant reduction of intrathecal morphine-induced pruritus and nausea and vomiting.

TRIAL REGISTRATION

CTRI/2015/01/005362 registered on 07/01/2015 in Clinical Trials Registry-India (ctri.nic.in).

Authors+Show Affiliations

Department of Anaesthesia and Critical Care, KIST Medical College, Imadol, Lalitpur, Nepal. dr.koju@gmail.com. Previously, Department of Anaesthesia and Critical Care, Patan Hospital, Patan, Lalitpur, Nepal. dr.koju@gmail.com.Department of Obstetrics and Gynaecology, KIST Medical College, Imadol, Lalitpur, Nepal. drbandanamd@gmail.com.Department of Biochemistry, KIST Medical College, Imadol, Lalitpur, Nepal. theyashad@gmail.com.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25971957

Citation

Koju, Ram Bhakta, et al. "Prophylactic Administration of Ondansetron in Prevention of Intrathecal Morphine-induced Pruritus and Post-operative Nausea and Vomiting in Patients Undergoing Caesarean Section." BMC Anesthesiology, vol. 15, 2015, p. 18.
Koju RB, Gurung BS, Dongol Y. Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section. BMC Anesthesiol. 2015;15:18.
Koju, R. B., Gurung, B. S., & Dongol, Y. (2015). Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section. BMC Anesthesiology, 15, 18. https://doi.org/10.1186/1471-2253-15-18
Koju RB, Gurung BS, Dongol Y. Prophylactic Administration of Ondansetron in Prevention of Intrathecal Morphine-induced Pruritus and Post-operative Nausea and Vomiting in Patients Undergoing Caesarean Section. BMC Anesthesiol. 2015 Feb 17;15:18. PubMed PMID: 25971957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section. AU - Koju,Ram Bhakta, AU - Gurung,Bandana Sharma, AU - Dongol,Yashad, Y1 - 2015/02/17/ PY - 2014/07/25/received PY - 2015/01/15/accepted PY - 2015/5/15/entrez PY - 2015/5/15/pubmed PY - 2015/12/19/medline SP - 18 EP - 18 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 15 N2 - BACKGROUND: Intrathecal morphine is commonly used for post caesarean analgesia. However, their use is frequently associated with the incidence of troublesome side effects such as nausea, vomiting and pruritus. Various mechanisms have been postulated for the opioid-induced pruritus, with a variety of medications with different mechanisms of actions formulated for the prevention and treatment. But, the results are inconsistent and hence the prevention and treatment of opioid-induced pruritus still remains a challenge. Ondansetron which is antiemetic, non-sedative and has no antianalgesic effect is an antagonist to 5-HT3 receptor, the receptor with which opioids interacts and imparts its effects. Ondansetron, thus, would be an attractive treatment strategy for both opioid-induced pruritus and post-operative nausea and vomiting. METHODS: After the approval from institutional review committee and written consent received from the patient, 50 healthy parturients of ASA I and II physical status undergoing caesarean section under spinal anaesthesia were enrolled for the study. They were randomly categorized into placebo group (2 ml normal saline) and treatment group (2 ml of 4 mg ondansetron), each group containing 25 patients. Pruritus and post-operative nausea and vomiting scores were recorded up to 24 hours after the administration of intrathecal morphine. Statistical analysis was performed using chi-square test. RESULTS: The incidence, severity and necessity of treatment for pruritus in the treatment group was significantly reduced compared to the placebo group (16% vs 88%). Similarly, the risk of post-operative nausea and vomiting in the treatment group was less compared to the placebo group (8% vs 56%). CONCLUSION: Prophylactic administration of ondansetron to parturients receiving intrathecal morphine for post-operative analgesia provides a significant reduction of intrathecal morphine-induced pruritus and nausea and vomiting. TRIAL REGISTRATION: CTRI/2015/01/005362 registered on 07/01/2015 in Clinical Trials Registry-India (ctri.nic.in). SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/25971957/Prophylactic_administration_of_ondansetron_in_prevention_of_intrathecal_morphine_induced_pruritus_and_post_operative_nausea_and_vomiting_in_patients_undergoing_caesarean_section_ L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/1471-2253-15-18 DB - PRIME DP - Unbound Medicine ER -