Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-19T17:41:28.051Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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