Prophylactic administration of ondansetron in prevention of intrathecal morphine-induced pruritus and post-operative nausea and vomiting in patients undergoing caesarean section

BMC Anesthesiology

Research Article

Ram Bhakta Koju¹  Yashad Dongol²  Bandana Sharma Gurung³ 

[1] Department of Anaesthesia and Critical Care, KIST Medical College, Imadol, Lalitpur, Nepal;Previously, Department of Anaesthesia and Critical Care, Patan Hospital, Patan, Lalitpur, Nepal;Department of Biochemistry, KIST Medical College, Imadol, Lalitpur, Nepal;Department of Obstetrics and Gynaecology, KIST Medical College, Imadol, Lalitpur, Nepal;

关键词: Caesarean section;    Intrathecal morphine;    Nausea and vomiting;    Ondansetron;    Opioids;    Pruritus;   

DOI  :  10.1186/1471-2253-15-18

 received in 2014-07-25, accepted in 2015-01-15,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIntrathecal 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.MethodsAfter 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.ResultsThe 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%).ConclusionProphylactic 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 registrationCTRI/2015/01/005362 registered on 07/01/2015 in Clinical Trials Registry – India (ctri.nic.in).

【 授权许可】

CC BY   
© Koju et al.; licensee BioMed Central. 2015