Yeh H M, Chen L K, Lin C J, Chan W H, Chen Y P, Lin C S, Sun W Z, Wang M J, Tsai S K
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Anesth Analg. 2000 Jul;91(1):172-5. doi: 10.1097/00000539-200007000-00032.
Pruritus is a common side effect of intrathecal morphine injection for postoperative pain control. Its incidence is especially high in patients undergoing cesarean delivery. We investigated the effectiveness of ondansetron in preventing intrathecal morphine-induced pruritus in such patients. We included 60 consecutive nonbreastfeeding women who were scheduled for elective cesarean delivery. After the administration of spinal anesthesia with bupivacaine and intrathecal morphine 0.15 mg injection, the patients were randomly divided into three groups. Group 1 received placebo (normal saline) IV injection, Group 2 diphenhydramine 30 mg IV injection, and Group 3 ondansetron 0.1 mg/kg IV injection. The incidence of pruritus was significantly lower in the ondansetron group (25%) when compared with that in the placebo group (85%) and in the diphenhydramine group (80%) (both P < 0.05). The postoperative pain score and time to flatus passage were not significantly different among the three groups. There were no headache or extrapyramidal signs associated with ondansetron use. In conclusion, ondansetron prophylaxis significantly reduced the incidence of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery.
Ondansetron prophylaxis significantly decreases the incidence of pruritus, a common side effect of intrathecal morphine used to treat postcesarean delivery pain.
瘙痒是鞘内注射吗啡用于术后疼痛控制的常见副作用。其发生率在剖宫产患者中尤其高。我们研究了昂丹司琼在预防此类患者鞘内注射吗啡引起的瘙痒方面的有效性。我们纳入了60例连续的非母乳喂养且计划进行择期剖宫产的女性。在使用布比卡因进行脊髓麻醉并鞘内注射0.15 mg吗啡后，将患者随机分为三组。第1组静脉注射安慰剂（生理盐水），第2组静脉注射30 mg苯海拉明，第3组静脉注射0.1 mg/kg昂丹司琼。与安慰剂组（85%）和苯海拉明组（80%）相比，昂丹司琼组的瘙痒发生率显著更低（25%）（P均<0.05）。三组之间的术后疼痛评分和排气时间无显著差异。未出现与使用昂丹司琼相关的头痛或锥体外系症状。总之，预防性使用昂丹司琼显著降低了剖宫产患者鞘内注射吗啡引起的瘙痒发生率。
预防性使用昂丹司琼可显著降低瘙痒的发生率，瘙痒是用于治疗剖宫产术后疼痛的鞘内吗啡的常见副作用。
