| Ondansetron is as effective as diphenhydramine for treatment of morphine-induced pruritus after cesarean delivery. | |
| | |
MedLine Citation:
|
PMID: 20236094 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Subarachnoid (SA) morphine, highly effective for the management of pain after a cesarean delivery, is associated with a significant incidence of pruritus in up to 80% of patients. No previous study has compared the effectiveness of ondansetron (5-HT(3) antagonist) vs. diphenhydramine (H(1) receptor blocker) for the treatment of this side effect. METHODS: In this randomized, double-blind study, 113 patients with a pruritus score 3 or 4 (1=absent; 2=mild, no treatment required; 3=moderate pruritus, treatment required; and 4=severe pruritus) after SA morphine 0.2 mg were assigned to group ondansetron, which received 4 mg intravenously (i.v.) ondansetron, and group diphenhydramine, which received 25 mg i.v. diphenhydramine. Patients who continued to have pruritus > or =3, 30 min after the study drug were considered treatment failures and were treated with naloxone 0.04 mg i.v. repeatedly, as well as patients who relapsed. Pain scores, nausea, vomiting, and sedation were determined before and 30 min after the study drugs were administered. Patients were followed up for 24 h. RESULTS: The success rate was comparable between the two groups [40/57 (70%) and 38/56 (70%), P=0.79, in group ondansetron and group diphenhydramine, respectively]. Among the successfully treated patients, the recurrence rates of moderate to severe pruritus were 11/40 (28%) in group ondansetron and 13/38 (35%) in group diphenhydramine, P=0.52. The side effect profile was similar between the two groups. CONCLUSION: Ondansetron is as effective as diphenhydramine in relieving pruritus caused by SA morphine in patients undergoing a cesarean delivery. However, up to 50% of patients required naloxone either for primary failure or for recurrence. |
| | |
Authors:
|
S M Siddik-Sayyid; V G Yazbeck-Karam; B W Zahreddine; A M B F Adham; C M Dagher; W A Saasouh; M T Aouad |
Related Documents
:
|
11696124 - Prevention of vomiting after strabismus surgery in children: dexamethasone alone versus... 19401664 - Comparison of intravenous and peritonsillar infiltration of tramadol for postoperative ... 10052024 - The impact of the menstrual cycle and ondansetron on postoperative nausea and vomiting. 22994024 - Effectiveness of a preoperative single dose intravenous dexamethasone in reducing the p... 19205684 - Relevance of the bonn risk index for metabolic monitoring of patients with calcium oxal... 9623364 - Treatment of iga nephropathy with nephrotic syndrome using pulse doses of igg. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2010-03-15 |
Journal Detail:
|
Title: Acta anaesthesiologica Scandinavica Volume: 54 ISSN: 1399-6576 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-07-12 Completed Date: 2010-10-19 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
|
Languages: eng Pagination: 764-9 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Cesarean Section* Diphenhydramine / therapeutic use* Double-Blind Method Female Histamine H1 Antagonists / therapeutic use* Humans Morphine / adverse effects*, therapeutic use Naloxone / therapeutic use Narcotic Antagonists / therapeutic use Narcotics / adverse effects*, therapeutic use Ondansetron / therapeutic use* Pain, Postoperative / drug therapy* Patient Satisfaction Postoperative Nausea and Vomiting / epidemiology Pregnancy Pruritus / chemically induced, drug therapy* Recurrence Serotonin Antagonists / therapeutic use* Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
|
0/Histamine H1 Antagonists; 0/Narcotic Antagonists; 0/Narcotics; 0/Serotonin Antagonists; 465-65-6/Naloxone; 57-27-2/Morphine; 58-73-1/Diphenhydramine; 99614-02-5/Ondansetron |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Reducing delirium in elderly patients with hip fracture: a multi-factorial intervention study.
Next Document: Long-term effect of the ICU-diary concept on quality of life after critical illness.