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

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    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
    Issue Date
    2012-02-01T10:58:27Z
    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
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    Citation
    Int J Obstet Anesth. 2010 Jan;19(1):56-60. Epub 2009 Nov 27.
    Journal
    International journal of obstetric anesthesia
    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
    ISSN
    1532-3374 (Electronic)
    0959-289X (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijoa.2009.05.005
    Scopus Count
    Collections
    Coombe Women & Infants University Hospital

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