Management of Opioid-Induced Pruritus: A Role for 5-HT3 Antagonists?

Comparison of intrathecal morphine and surgical-site infusion of ropivacaine as adjuncts to intravenous patient-controlled analgesia in living-donor kidney transplant recipients

“…Although most pruritus symptoms in this study were relieved by antihistamines, histamine is not released in intrathecal opioid-induced pruritus and does not appear to be causative. (19,20) Therefore, symptom relief may have been associated with the sedative properties of antihistamines rather than actual relief of the itching sensation. Moreover, antihistamines may enhance the sedative effects of opioids, which could be dangerous when intrathecal opioid is involved.…”

5-Hydroxytryptamine (5-HT)2 Receptor Involvement in Acute 5-HT-Evoked Scratching but Not in Allergic Pruritus Induced by Dinitrofluorobenzene in Rats

“…One goal of the present study was therefore to investigate which 5-HT receptor subtypes are involved in acute scratching elicited by intradermal 5-HT in the rat. Although 5-HT 3 receptors have been implicated in itch associated with cholestasis, uremia, and spinal opioids (Schworer et al, 1995;Balaskas et al, 1998;Kyriakides et al, 1999), 5-HT 3 receptor antagonists did not affect scratching elicited by intradermal 5-HT in mice, in contrast to the blockade of scratching by 5-HT 2 antagonists (Yamaguchi et al, 1999). These data argue against a role for 5-HT 3 receptors in acute evoked scratching in mice.…”

Antipruritic and antiemetic effect of epidural droperidol

“…Opioids also act in areas of the brain (probably medulla oblongata) to cause itching [8]. Neuraxial opioids can also itching by acting on serotonin (5-hydroxytryptamine) Type III receptors in the dorsal part of spinal cord and the nucleus of the spinal tract of the trigeminal nerve in the medulla [9,10].…”