Epidural ondansetron is more effective to prevent postoperative pruritus and nausea than intravenous ondansetron in elective cesarean delivery.
BACKGROUND
Postoperative pruritus, nausea, and vomiting are common side effects of intrathecal or epidural opioids. Intravenous ondansetron has been used for postoperative emesis. However, there are no reports regarding epidural ondansetron. Two studies were conducted to evaluate the prophylactic effects of epidural ondansetron for opioid-induced pruritus, nausea, and vomiting.


METHODS
Neurotoxic signs were checked after epidural injection of ondansetron in rats. A clinical study was conducted to compare the prophylactic effects of epidural ondansetron with intravenous ondansetron for opioid-induced pruritus, nausea, and vomiting in cesarean delivery.


RESULTS
No neurotoxic evidence was found in rats. The incidence of pruritus and nausea was significantly lower in the epidural ondansetron group than in the intravenous ondansetron group at 24 and 48 h postoperatively.


CONCLUSIONS
Epidural ondansetron is more effective in preventing postoperative pruritus and nausea than intravenous ondansetron.
Han
Dong Woo
DW
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Korea.
Hong
Soon Won
SW
Kwon
Ja-Young
JY
Lee
Jae Woo
JW
Kim
Ki Jun
KJ
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects; D000767:Anesthesia, Epidural / Q000379:methods*; D000818:Animals; D000932:Antiemetics / Q000008:administration & dosage; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008854:Microscopy, Electron; D017294:Ondansetron / Q000008:administration & dosage*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D011247:Pregnancy; D011537:Pruritus / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012702:Serotonin Antagonists / Q000008:administration & dosage*; D013116:Spinal Cord / Q000648:ultrastructure
D000701:Analgesics, Opioid; D000932:Antiemetics; D012702:Serotonin Antagonists; D017294:Ondansetron