Santayana's prophecy fulfilled

Ondansetron is effective in treatment pruritus after intrathecal fentanyl

“…Pruritus after intrathecal fentanyl is related to a direct central effect on brain stem opiate receptors. 1 Traditional treatment includes parenteral diphenhydramine and naloxone. Occasionally pruritus is resistant to traditional treatment.…”

“…Fentanyl is a strong opioid agonist and combines with the mu receptors to produce analgesia and can trigger the release of mediators of pruritus. 1 . Pruritis can be induced by the release of histamine or serotonin.…”

“…In our case, fentanyl produced pruritus in the same dermatomes the spinal blocked. There is a "scratching center" described in the medulla oblongata of animals, 1 and there is a correlate in the human brainstem. Although most common on the trunk and lower extremities, pruritus from intrathecal opioids sometimes occurs in remote areas, such as nasal and facial pruritus.…”

“…Regardless, in none of them was resolution complete as implied. 1 For these patients, despite improvement of the myelopathy, they were, in all probability, lifetime problems as can be attested to by medicolegal cases 2 or more years after their occurrences.…”

“…1 Foldes and Mc-Nall reported 214 not 433 patients 6 and why is it not "perplexing." In the "NOTE" of Table 1 of the article by Winnie and Nader 1 they explained the reason by stating "The preparation of 2-chloroprocaine used by Foldes and McNall for their first studies in humans was a white powder .…”