A Comparison of the Incidence of Pruritus Following Epidural Opioid Administration in the Parturient

Epidural butorphanol-bupivacaine analgesia for postoperative pain relief after abdominal hysterectomy

“…Previous studies have shown significantly lower frequencies of pruritus, nausea, and vomiting in patients receiving epidural butorphanol as compared with epidural morphine and fentanyl [4-8, ⁎ , † ]. Ackerman et al [8] showed that 60% of patients receiving epidural morphine and 46.7% of patient receiving epidural fentanyl developed pruritus as compared with only 6.7% of patients in the epidural butorphanol group. None of the patients developed pruritus in the present study.…”

The effect of the addition of ropivacaine or bupivacaine upon pruritus induced by intrathecal fentanyl in labour

“…Bupivacaine decreases opioid binding to the µ‐receptor and increases opioid binding to the δ‐ and κ‐receptors [23]. Binding to κ‐receptors has been shown to decrease pruritus from µ‐receptor binding [24]. The inability to decrease pruritus over the upper part of the body may be due to inadequate neuronal blockade in the ventrolateral tracts of the spinal cord or direct fentanyl action at the brainstem and upper part of the spinal cord.…”

Side‐effects of epidural infusions of opioid bupivacaine mixtures

“…The incidences of side-effects quoted in previous studies vary considerably and are dependent upon the dose and mode of administration making an assessment of power for this study difficult. Using previous results for morphine and fentanyl (the two most commonly studied opioids) the power of the current study was calculated as 0.8 for nausea and vomiting and 0.7 for pruritis (a ¼ 0.05) [5,6,[9][10][11][12][13]. Previous results for morphine and methadone gave the power of the current study for urinary retention as > 0.95 (a ¼ 0.05) [12,14,15].…”