The impact of intraoperative propofol administration in the prevention of postoperative pruritus induced by epidural morphine.
OBJECTIVE
We examined the efficacy of intraoperative propofol administration to prevent pruritus induced by epidural morphine.


METHODS
Seventy patients ASA I-II undergoing combined epidural and general anaesthesia for hysterectomy were randomly assigned to two groups, Group P where anaesthesia was induced with propofol and fentanyl and maintained with propofol-nitrous oxide and Group S in which anaesthesia was induced with thiopental and fentanyl and maintained with sevoflurane-nitrous oxide. All patients received a ropivacaine epidural bolus with 3 mg morphine 1 h before the end of surgery. The incidence and severity of pruritus were evaluated every 4 h for the first 12 h postoperatively by blinded observers.


RESULTS
The total incidence of pruritus was significantly higher (P = 0.024) in Group S (65.6%) compared to Group P (29%) between 4 and 8 h postoperatively. There were also significantly more patients (P = 0.03) reporting severe pruritus in Group S (22%) compared to Group P (0).


CONCLUSIONS
Propofol-based general anaesthesia compared to thiopental-sevoflurane-based anaesthesia reduces the incidence and severity of pruritus induced by a single injection of 3 mg epidural morphine with ropivacaine.
University of Athens, Attikon Hospital, School of Medicine, Athens, Greece.
G
G
Kostopanagiotou
A
A
Pandazi
S
S
Matiatou
S
S
Kontogiannopoulou
P
P
Matsota
D
D
Niokou
M
M
Kitsou
E
E
Crepi
K
K
Christodoulaki
I
I
Grigoropoulou
D015360:Analgesia, Epidural / Q000009:adverse effects*; D000701:Analgesics, Opioid / Q000009:adverse effects; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D017558:Elective Surgical Procedures; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007044:Hysterectomy; D007430:Intraoperative Care / Q000379:methods*; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects*; D009609:Nitrous Oxide / Q000008:administration & dosage; D011183:Postoperative Complications / Q000139:chemically induced / Q000517:prevention & control*; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D011537:Pruritus / Q000139:chemically induced / Q000517:prevention & control*; D012720:Severity of Illness Index; D000077149:Sevoflurane; D013874:Thiopental / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D009020:Morphine; D013874:Thiopental; D009609:Nitrous Oxide; D005283:Fentanyl; D015742:Propofol