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The impact of intraoperative propofol administration in the prevention of postoperative pruritus induced by epidural morphine

Published online by Cambridge University Press:  10 February 2006

G. Kostopanagiotou ,
A. Pandazi ,
S. Matiatou ,
S. Kontogiannopoulou ,
P. Matsota ,
D. Niokou ,
M. Kitsou ,
E. Crepi ,
K. Christodoulaki  and
I. Grigoropoulou
G. Kostopanagiotou
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
A. Pandazi
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
S. Matiatou
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
S. Kontogiannopoulou
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
P. Matsota
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
D. Niokou
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
M. Kitsou
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
E. Crepi
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
K. Christodoulaki
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
I. Grigoropoulou
Affiliation:
University of Athens, Attikon Hospital, School of Medicine, 2nd Clinic of Anaesthesiology, Athens, Greece
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Abstract

Summary

Background and 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). Conclusion: 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.

Keywords

ANAESTHESIA EPIDURAL, side-effects, pruritusOPIOIDS, morphineANAESTHETICS INTRAVENOUS, propofol
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 5 , May 2006 , pp. 418 - 421
Copyright
2006 European Society of Anaesthesiology

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References

Szarvas S, Harmon D, Murphy D. Neuraxial opioid-induced pruritus: a review. J Clin Anesth 2003; 15: 234–239.Google Scholar
Saiah M, Borgeat A, Wilder-Smith OH, Rifat K, Suter PM. Epidural-morphine-induced pruritus: propofol versus naloxone. Anesth Analg 1994; 78: 1110–1113.Google Scholar
Beilin Y, Bernstein HH, Zucker-Pinchoff B, Zahn J, Zenzen WJ. Subhypnotic doses of propofol do not relieve pruritus induced by intrathecal morphine after cesarean section. Anesth Analg 1998; 86: 310–313.Google Scholar
Kjellberg F, Tramer M. Pharmacological control of opioid-induced pruritus: a quantitative systematic review of randomized trials. Eur J Anaesth 2001; 18: 346–357.Google Scholar
Horta M, Lourenco R, Goncalves Z. Inhibition of epidural morphine-induced pruritus by epidural droperidol. Anesth Analg 2000; 90: 638–641.Google Scholar
Ballantyne J, Loach A, Carr D. Itching after epidural and spinal opiates. Pain 1988; 33: 149–160.Google Scholar
Borgeat A, Wilder-Smith OH, Suter PM. The nonhypnotic therapeutic applications of propofol. Anesthesiology 1994; 80: 642–656.Google Scholar
Gan T, Ginsberg B, Grant A, Glass P. Double blind, randomized comparison of ondansetron and intraoperative propofol to prevent postoperative nausea and vomiting. Anesthesiology 1996; 85: 1036–1042.Google Scholar
Grattidge P. Nausea and vomiting after major arthroplasty with spinal anaesthesia including morphine: a randomized trial of subhypnotic propofol infusion as prophylaxis. Acta Anaesthesiol Scand 1998; 42: 124–127.Google Scholar
Torn K, Tuominen M, Tarkkila P, Lindgren L. Effects of sub-hypnotic doses of propofol on the side-effects of intrathecal morphine. Br J Anaesth 1994; 73: 411–412.Google Scholar
Warwick J, Kearns C, Scott W. The effect of subhypnotic doses of propofol on the incidence of pruritus after intrathecal morphine for cesarean section. Anaesthesia 1997; 52: 270–275.Google Scholar
Borgeat A, Wilder-Smith OH, Saiah M, Rifat K. Subhypnotic doses of propofol relieve pruritus induced by epidural and intrathecal morphine. Anesthesiology 1992; 76: 510–512.Google Scholar
Yeh H, Chen L, Lin Cet al. Prophylactic intravenous ondansetron reduces the incidence of intrathecal morphine-induced pruritus in patients undergoing cesarean delivery. Anesth Analg 2000; 911: 172–175.Google Scholar