Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron.

Hdl Handle:
http://hdl.handle.net/10147/208039
Title:
Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron.
Authors:
Tan, T; Ojo, R; Immani, S; Choroszczak, P; Carey, M
Affiliation:
Department of Anaesthesia and Perioperative Medicine, Coombe Women and Infants, University Hospital, Dublin, Ireland. tutan@me.com
Citation:
Int J Obstet Anesth. 2010 Jan;19(1):56-60. Epub 2009 Nov 27.
Journal:
International journal of obstetric anesthesia
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/208039
DOI:
10.1016/j.ijoa.2009.05.005
PubMed ID:
19945275
Abstract:
BACKGROUND: The incidence of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine may be 60-100%, and is a common cause of maternal dissatisfaction. Ondansetron has been shown to reduce pruritus but the effect is short-lived. The objective of this randomized double-blind trial was to evaluate the anti-pruritic efficacy of granisetron compared with ondansetron. METHODS: Eighty ASA I or II women undergoing elective caesarean section received spinal anaesthesia with 0.5% hyperbaric bupivacaine 10 mg, fentanyl 25 microg and preservative-free morphine 150 microg. After delivery of the baby and clamping of the umbilical cord, they were randomised to receive granisetron 3mg i.v. (group G) or ondansetron 8 mg i.v. (group O). RESULTS: The two groups were similar for age, gestational age, height and weight. According to visual analogue pruritus scores, patients in group G experienced less pruritus at 8h (P=0.003) and 24h (P=0.01). Fewer patients in group G (n=8) than group O (n=18) required rescue anti-pruritic medication (P=0.03). Satisfaction scores were also higher in group G than in group O (P=0.03). There was no difference in overall incidence of pruritus, nausea and vomiting, and visual analogue pain scores between the two groups. CONCLUSIONS: Administration of granisetron 3mg i.v. reduces the severity of pruritus and the use of rescue anti-pruritic medication, and improves satisfaction but does not reduce the overall incidence of pruritus in women who have received subarachnoid morphine 150 microg compared to ondansetron 8 mg i.v.
Language:
eng
MeSH:
Adult; Analgesics, Opioid/*adverse effects; *Anesthesia, Obstetrical; Anesthesia, Spinal/*adverse effects; *Cesarean Section; Double-Blind Method; Female; Granisetron/administration & dosage/*therapeutic use; Humans; Injections; Morphine/*adverse effects; Ondansetron/administration & dosage/*therapeutic use; Pain Measurement; Patient Satisfaction; Postoperative Complications/*chemically induced/*prevention & control; Postoperative Nausea and Vomiting/prevention & control; Pregnancy; Pruritus/*chemically induced/*prevention & control; Serotonin Antagonists/administration & dosage/*therapeutic use; Subarachnoid Space; Surgical Procedures, Elective
ISSN:
1532-3374 (Electronic); 0959-289X (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorTan, Ten_GB
dc.contributor.authorOjo, Ren_GB
dc.contributor.authorImmani, Sen_GB
dc.contributor.authorChoroszczak, Pen_GB
dc.contributor.authorCarey, Men_GB
dc.date.accessioned2012-02-01T10:58:27Z-
dc.date.available2012-02-01T10:58:27Z-
dc.date.issued2012-02-01T10:58:27Z-
dc.identifier.citationInt J Obstet Anesth. 2010 Jan;19(1):56-60. Epub 2009 Nov 27.en_GB
dc.identifier.issn1532-3374 (Electronic)en_GB
dc.identifier.issn0959-289X (Linking)en_GB
dc.identifier.pmid19945275en_GB
dc.identifier.doi10.1016/j.ijoa.2009.05.005en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208039-
dc.description.abstractBACKGROUND: The incidence of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine may be 60-100%, and is a common cause of maternal dissatisfaction. Ondansetron has been shown to reduce pruritus but the effect is short-lived. The objective of this randomized double-blind trial was to evaluate the anti-pruritic efficacy of granisetron compared with ondansetron. METHODS: Eighty ASA I or II women undergoing elective caesarean section received spinal anaesthesia with 0.5% hyperbaric bupivacaine 10 mg, fentanyl 25 microg and preservative-free morphine 150 microg. After delivery of the baby and clamping of the umbilical cord, they were randomised to receive granisetron 3mg i.v. (group G) or ondansetron 8 mg i.v. (group O). RESULTS: The two groups were similar for age, gestational age, height and weight. According to visual analogue pruritus scores, patients in group G experienced less pruritus at 8h (P=0.003) and 24h (P=0.01). Fewer patients in group G (n=8) than group O (n=18) required rescue anti-pruritic medication (P=0.03). Satisfaction scores were also higher in group G than in group O (P=0.03). There was no difference in overall incidence of pruritus, nausea and vomiting, and visual analogue pain scores between the two groups. CONCLUSIONS: Administration of granisetron 3mg i.v. reduces the severity of pruritus and the use of rescue anti-pruritic medication, and improves satisfaction but does not reduce the overall incidence of pruritus in women who have received subarachnoid morphine 150 microg compared to ondansetron 8 mg i.v.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnalgesics, Opioid/*adverse effectsen_GB
dc.subject.mesh*Anesthesia, Obstetricalen_GB
dc.subject.meshAnesthesia, Spinal/*adverse effectsen_GB
dc.subject.mesh*Cesarean Sectionen_GB
dc.subject.meshDouble-Blind Methoden_GB
dc.subject.meshFemaleen_GB
dc.subject.meshGranisetron/administration & dosage/*therapeutic useen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInjectionsen_GB
dc.subject.meshMorphine/*adverse effectsen_GB
dc.subject.meshOndansetron/administration & dosage/*therapeutic useen_GB
dc.subject.meshPain Measurementen_GB
dc.subject.meshPatient Satisfactionen_GB
dc.subject.meshPostoperative Complications/*chemically induced/*prevention & controlen_GB
dc.subject.meshPostoperative Nausea and Vomiting/prevention & controlen_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshPruritus/*chemically induced/*prevention & controlen_GB
dc.subject.meshSerotonin Antagonists/administration & dosage/*therapeutic useen_GB
dc.subject.meshSubarachnoid Spaceen_GB
dc.subject.meshSurgical Procedures, Electiveen_GB
dc.titleReduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Perioperative Medicine, Coombe Women and Infants, University Hospital, Dublin, Ireland. tutan@me.comen_GB
dc.identifier.journalInternational journal of obstetric anesthesiaen_GB
dc.description.provinceLeinster-

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