The comparative study of intravenous Ondansetron and sub-hypnotic Propofol dose in control and treatment of intrathecal Sufentanil-induced pruritus in elective caesarean surgery

Anahita Hirmanpour, Mohammadreza Safavi, Azim Honarmand, Akram Zavaran Hosseini, Maryam Sepehrian, Anahita Hirmanpour, Mohammadreza Safavi, Azim Honarmand, Akram Zavaran Hosseini, Maryam Sepehrian

Abstract

Objective: Pruritus is a common and disturbing side effect of neuraxial opioids after cesarean section. The purpose of this study was to compare the efficacy of intravenous ondansetron and sub-hypnotic dose of propofol in control and treatment of intrathecal sufentanil induced pruritus in cesarean surgery.

Methods: Totally, 90 parturient with American Society of Anesthesiology physical status grade I-II, undergoing spinal anesthesia with 2.5 μg sufentanil and 10 mg bupivacaine 0.5% were enrolled to this randomized, prospective, double-blind study. The women were randomly assigned to two groups who received 8 mg ondansetron or 10 mg propofol to treat pruritus grade ≥3. The patient was evaluated after 5 min and in the lack of successful treatment, the doses of two drugs repeated and if the pruritus is on-going, the exact treatment with naloxone was done.

Findings: The incidence of pruritus was 69.3%. Both groups were well-matched. The peak time pruritus was 30-75 min after injection. The percentage of individuals consumed naloxone were 6.8% and 15.9% in ondansetron and propofol groups, respectively (P = 0.18). The mean score of satisfaction (according to visual analog scale criteria) was 9.09 ± 1.1 in ondansetron group and 9.3 ± 1.07 in the propofol group (P = 0.39).

Conclusion: Ondansetrone and sub-hypnotic dose of propofol are both safe and well-tolerated. Due to their same efficacy in the treatment of intrathecal sufentanil-induced pruritus, they can be widely used in clinical practice.

Keywords: Caesarean surgery; Ondansetron; Propofol; intrathecal opioid; pruritus.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT diagram of the study
Figure 2
Figure 2
Mean systole blood pressure (mmHg) from pre-surgery to the end of recovery (P = 0.07)
Figure 3
Figure 3
Mean diastole blood pressure (mmHg) from pre-surgery to the end of recovery (P = 0.52)
Figure 4
Figure 4
Mean arterial pressure (mmHg) from pre-surgery to the end of recovery (P = 0.26)
Figure 5
Figure 5
Mean heart rate (beats/min) from pre-surgery to the end of recovery (P = 0.99)
Figure 6
Figure 6
Mean SpO2 (%) from pre-surgery to the end of recovery (P = 0.20)
Figure 7
Figure 7
Mean pruritus intensity from pre-surgery to the end of recovery (P = 0.44)

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