Ondansetron for treatment of intrathecal morphine-induced pruritus after cesarean delivery

Charuluxananan, Somrat; Somboonviboon, Wanna; Kyokong, Oranuch; Nimcharoendee, K.

doi:10.1053/rapm.2000.7809

Cited by 42 publications

(40 citation statements)

References 33 publications

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“…The precise cause of pruritus is not clear but the most convincing hypothesis remains that pruritus is caused by a direct, excitatory effect of morphine on the dorsal horn of the spinal cord and the trigeminal nuclei by the cephalad migration of morphine following its epidural administration. 6,7,13 Since both the 5-HT 3 and µ-opioid receptor systems in the central nervous system are involved in the regulation of pruritus, [1][2][3]6,7,[14][15][16] ondansetron may exert its anti-pruritic action through one or both of these receptor systems.…”

Section: Objectif : éValuer L'effet Prophylactique De L'ondansétron Smentioning

confidence: 99%

Prophylacticiv ondansetron reduces nausea, vomiting and pruritus following epidural morphine for postoperative pain control

Tzeng

Chu

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To evaluate the prophylactic effect of ondansetron on nausea and vomiting following epidural morphine for postoperative pain control.M Me et th ho od ds s: : Seventy women (n = 35 in each group) undergoing abdominal total hysterectomy under epidural anesthesia were enrolled in this randomized, double-blinded, and placebo-controlled study. At the end of surgery, all patients received epidural morphine 3 mg for postoperative pain relief. Before morphine injection, the ondansetron group received iv ondansetron 4 mg, whereas the placebo group received iv saline.

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Section: Objectif : éValuer L'effet Prophylactique De L'ondansétron Smentioning

confidence: 99%

Prophylacticiv ondansetron reduces nausea, vomiting and pruritus following epidural morphine for postoperative pain control

Tzeng

Chu

et al. 2003

Can J Anesth/J Can Anesth

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“…4,5 It has been used as a treatment for tic disorders, 6 tardive dyskinesia, 7 and alcoholism. 8,9 It has also been successfully trialed in patients with tinnitus, 10 fatigue related to chronic hepatitis, 11 and opiaterelated pruritus, 12 but not benzodiazepine withdrawal. 13 Given that antipsychotic drugs can augment the benefits of SRIs in patients with OCD, might ondansetron carry similar benefits?…”

Section: Introductionmentioning

confidence: 99%

Ondansetron Augmentation of Serotonin Reuptake Inhibitors as a Treatment Strategy in Obsessive-Compulsive Disorder

Andrade

2015

J. Clin. Psychiatry

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“…However, the side effects of opioids, which can affect patient comfort and safety, restrict the therapeutic effects. Itching is the most frequently seen side effect of intrathecal morphine, with an incidence ranging 62–94% [2, 3]. Itching continues to be a challenging and problematic issue that is difficult for anesthetists to treat [4, 5].…”

mentioning

confidence: 99%

Comparison of Mirtazapine,Gabapentin and Ondansetron to prevent intrathecal morphine induced pruritus

Akhan

Subaşı

Bosna

et al. 2016

North Clin Istanbul

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OBJECTIVE:Antagonism of the central nervous system inhibitor neurotransmitter gamma-Aminobutyric acid (GABA) or serotonergic system activation is an important factor in the pathogenesis of intrathecal morphine-induced pruritus. This study tested the hypothesis that preoperative use of ondansetron, gabapentin or mirtazapine can prevent morphine-induced pruritus.METHODS:We randomly allocated 80 patients of American Society of Anesthesiology (ASA) classification I and II physical status who were to undergo unilateral inguinal hernia or pilonidal sinus operations under spinal anesthesia into 4 equal groups. The first 3 groups received oral doses of 30 mg mirtazapine, 8 mg ondansetron, and 1200 mg gabapentin at 2 hours, 10 minutes, and 1 hour before surgery, respectively, and the fourth group was given a placebo. All patients received intrathecal injection of 15 mg of 0.5% hyperbaric bupivacaine and 0.2 mg morphine. Pruritus was evaluated at 0, 3, 6, 9, 12, and 24 hours after intrathecal morphine administration, and details of presence, onset time, duration, localization, and severity of pruritus were recorded.RESULTS:Incidence of pruritus was significantly more frequent in the placebo group compared to ondansetron, gabapentin, and mirtazapine groups (70%, 55%, 35%, and 35%, respectively). In general, onset of pruritus was between 2 and 6 hours after intrathecal morphine injection; however, onset in the gabapentin group (mean±SD: 4.75±2.7 hours; p=0.019) was delayed compared to other groups. It was observed that pruritus persisted relatively longer in the ondansetron and placebo groups (mean±SD: 6±3.08; 5.82±2.96 hours, respectively; p=0.047). No statistical determination was made regarding location of pruritus. Severity of pruritus was greater in the placebo group (p=0.0001). Necessity for antipruritic treatment was not statistically significantly different between groups.CONCLUSION:Incidence and severity of intrathecal morphine-induced pruritus decreased with use of each of all 3 drugs compared to placebo.

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Ondansetron for treatment of intrathecal morphine-induced pruritus after cesarean delivery

Abstract: Ondansetron treats intrathecal morphine-induced pruritus after cesarean delivery, particularly in patients suffering from both nausea/vomiting and pruritus.

Cited by 42 publications

References 33 publications

Prophylacticiv ondansetron reduces nausea, vomiting and pruritus following epidural morphine for postoperative pain control

Prophylacticiv ondansetron reduces nausea, vomiting and pruritus following epidural morphine for postoperative pain control

Ondansetron Augmentation of Serotonin Reuptake Inhibitors as a Treatment Strategy in Obsessive-Compulsive Disorder

Comparison of Mirtazapine,Gabapentin and Ondansetron to prevent intrathecal morphine induced pruritus

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