Epidural-morphine-induced pruritus: propofol versus naloxone.
In a prospective, randomized, double-blind clinical trial, we compared the efficacy of propofol and naloxone for the treatment of spinal-morphine-induced pruritus. Forty patients presenting with severe pruritus within 24 h of epidural morphine administration were allocated to receive either propofol 10 mg intravenously (i.v.) or naloxone 2 micrograms/kg. In the absence of a positive response, a second dose of the same treatment was given 5 min later. Pruritus and the level of post-operative pain were assessed every 5 min up to the end of the study period (45 min) using a verbal rating scale. The overall success rate in treating pruritus was similar in the two groups (80%). The rate of success after the first injection of the treatment drug was also similar (55%). The level of postoperative pain decreased after drug treatment in six patients (30%) in the propofol group versus none in the naloxone group (P < 0.05). Forty-five percent of the patients in the naloxone group had an increase in the level of postoperative pain versus none in the propofol group (P < 0.05). In conclusion, these results suggest that propofol and naloxone are equally effective in treating spinal-morphine-induced pruritus. However, the level of postoperative pain is significantly less in the propofol group.
Saiah
M
M
Department of Anesthesiology and Surgical Intensive Care, University Hospital of Geneva, Switzerland.
Borgeat
A
A
Wilder-Smith
O H
OH
Rifat
K
K
Suter
P M
PM
D000328:Adult; D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects*; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects*; D009270:Naloxone / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000517:prevention & control*; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D011537:Pruritus / Q000139:chemically induced* / Q000517:prevention & control
D009270:Naloxone; D009020:Morphine; D015742:Propofol