Comparative study between the effects of Nalbuphine, Propofol, and Ondansetron for control of intrathecal opioid induced pruritus in parturients after Cesarean Section: Randomized Controlled Trial.

Mowafy, Sherif Mohammed Said; El Sayed, Mohamed

doi:10.21608/zumj.2020.26203.1775

Comparative study between the effects of Nalbuphine, Propofol, and Ondansetron for control of intrathecal opioid induced pruritus in parturients after Cesarean Section: Randomized Controlled Trial.

Document Type : Original Article

Authors

¹ Anesthesia and Surgical Intensive Care, Faculty of Medicine, Zagazig University

² Anesthesia and Intensive Care Department, Zagazig University, Faculty of Medicine

10.21608/zumj.2020.26203.1775

Abstract

Background:
Controlling intrathecal opioid induced pruritis is considered a significant challenge to anesthetists. The aim of this study was to compare the effects of Nalbuphine, Propofol, and Ondansteron in controlling intrathecal morphine induced pruritis to find out the best one with least side effects.
Methods:
248 parturients with moderate to severe pruritus after spinal anesthesia with 2 mg morphine added to 10 mg bupivacaine for cesarean section were included. According to the used drugs, they were randomized into four equal groups: Control group (Group C) received 10 ml of normal saline (as Placebo) IV, Nalbuphine group (Group N) received 4mg (0.2 ml) of 2% Nalbuphine diluted up to 10 ml with normal saline IV, Propofol group (Group P) received 20 mg (2 ml) of 1% Propofol diluted up to 10 ml with normal saline IV, and Ondansetron group (Group O) received 8 mg (4ml) of 0.2% Ondansetron diluted up to 10 ml with normal saline IV. The effects of interventional drugs in controlling pruritus and associated side effects were evaluated in each group.
Results:
Statistically, parturients' characteristics and pre-treatment pruritus scores distribution were comparable. The post-treatment pruritus scores distribution was highly significant decreased in Nalbuphine group and post-treatment success rate was highly significant in Nalbuphine group (93.6%) than in Propofol (71%) and Ondansetron groups (53.2%). No statistical significant difference was noticed regarding the adverse events in the studied groups.
Conclusion:
Nalbuphine (4mg) was superior to both Propofol (20mg) and Ondansteron (8mg) for treatment of intrathecal morphine-induced pruritus after cesarean section.

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