Document Detail


Ondansetron and tropisetron do not prevent intraspinal morphine- and fentanyl-induced pruritus in elective cesarean delivery.
MedLine Citation:
PMID:  16430549     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although intraspinal morphine has been shown to be effective in providing analgesia after cesarean delivery, pruritus as a side-effect remains a common cause of dissatisfaction. The role of ondansetron has been studied in preventing pruritus but the results have been contradictory. METHODS: We randomized 98 parturients undergoing elective cesarean section using combined spinal-epidural anesthesia into a double-blinded trial to receive tropisetron 5 mg (T group) or ondansetron 8 mg (O group) or placebo (NaCl group) after delivery, when intrathecal morphine 160 microg and fentanyl 15 microg were used for post-operative pain control. The patients additionally received ketoprofen 300 mg per day. Post-operative itching, nausea and vomiting, sedation and need for rescue analgesics were registered every 3 h up to 24 h, and all patients were interviewed on the first post-operative day. RESULTS: Seventy-six percent of the parturients in the placebo group, 87% in the ondansetron, and 79% in the tropisetron group had itching. The incidence of post-operative nausea and vomiting was 21%, 20% and 11% of the patients in the placebo, ondansetron and tropisetron groups, respectively. Medication for pruritus was needed by 31%, 23% and 39% of the patients in the placebo, ondansetron and tropisetron groups, respectively. In the post-operative questionnaire, the patients reported less post-operative nausea in the tropisetron group than in the placebo group (P < 0.01). CONCLUSION: Neither ondansetron nor tropisetron prevent itching caused by intrathecal morphine with fentanyl. However, tropisetron reduced post-operative nausea.
Authors:
P J Sarvela; P M Halonen; A I Soikkeli; J P Kainu; K T Korttila
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  50     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-24     Completed Date:  2006-05-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  239-44     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care, Helsinki University Central Hospital, Helsinki, Finland. Johanna.sarvela@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics, Opioid / administration & dosage,  adverse effects
Anesthesia, Epidural / methods
Anesthesia, Spinal / methods
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
Antiemetics / administration & dosage,  therapeutic use
Cesarean Section / methods*
Double-Blind Method
Female
Fentanyl / administration & dosage,  adverse effects*
Humans
Indoles / administration & dosage,  therapeutic use*
Injections, Spinal / methods
Ketoprofen / administration & dosage
Morphine / administration & dosage,  adverse effects*
Ondansetron / administration & dosage,  therapeutic use*
Pain, Postoperative / prevention & control
Postoperative Nausea and Vomiting / prevention & control
Pregnancy
Prospective Studies
Pruritus / chemically induced*
Surgical Procedures, Elective / methods
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Antiemetics; 0/Indoles; 22071-15-4/Ketoprofen; 437-38-7/Fentanyl; 57-27-2/Morphine; 89565-68-4/tropisetron; 99614-02-5/Ondansetron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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