Intrathecal fentanyl-induced pruritus during labour: the effect of prophylactic ondansetron

Wells, J. C. D.; Paech, Michael J.; Evans, Sharon F.

doi:10.1016/j.ijoa.2003.07.001

Cited by 29 publications

(31 citation statements)

References 25 publications

(24 reference statements)

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“…The overall incidence of pruritus after administration of 25 lg fentanyl as a protocol for CSEA was 90% in a randomized clinical trial study by Wells and coworkers. 21 There were 28% to 45% of patients in different groups needed a rescue antipruritic agent such as naloxane. Recently, Pitkanen and coworkers 22 revealed that the rate of fatality and neuraxial hematoma are significantly higher in epidural and CSEA than spinal anesthesia.…”

mentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy Under Spinal Versus General Anesthesia: A Randomized Clinical Trial

Nouralizadeh

Ziaee

Sharifi

et al. 2013

Journal of Endourology

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mentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy Under Spinal Versus General Anesthesia: A Randomized Clinical Trial

Nouralizadeh

Ziaee

Sharifi

et al. 2013

Journal of Endourology

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“…1,2 Of these side effects, pruritis is the most prevalent, with an incidence of 30% to 100% after neuraxial administration. [3][4][5] The incidence and severity of the pruritis that manifests has been shown to be dose dependent. 5,6 The mechanism of pruritis is complex and thought to be secondary to the stimulation of chemical, physical, and thermal receptors located in the central and peripheral nervous systems.…”

mentioning

confidence: 99%

Correlating an 11-Point Verbal Numeric Rating Scale to a 4-Point Verbal Rating Scale in the Measurement of Pruritis

Jenkins

Spencer²,

Weissgerber³

et al. 2009

Journal of PeriAnesthesia Nursing

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“…Some studies showed that neuraxial opioid-induced pruritus respond to prophylaxis (3,16,17) and treatment (5,18) with ondansetron. Other studies, however, concluded that ondansetron was not effective in this context (19)(20)(21). Ondansetron seems to be more effective in preventing pruritus induced by morphine than other more potent opioids such as fentanyl and sufentanil.…”

Section: Discussionmentioning

confidence: 96%

Ondansetron Treatment in a Child Presenting with Chronic Intractable Pruritus

Frigon

Desparmet

2006

Pain Research and Management

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The case of a seven-year-old boy with chronic pruritus secondary to a giant congenital melanocytic nevus is presented. The pruritus did not respond to conventional antipruritic drug treatment, but responded to ondansetron, a selective antagonist of 5-hydroxytryptamine type 3 receptors.Key Words: Children; Giant congenital melanocytic nevus; Ondansetron; Pruritus; Serotonin antagonist Un traitement à l'ondansétron pour un enfant atteint d'un prurit chronique réfractaire Est présenté le cas d'un garçon de sept ans atteint d'un prurit chronique secondaire à un naevus mélanocytique géant congénital. Le prurit n'a pas répondu à un traitement classique aux antipruritiques, mais a répondu à l'ondansétron, un antagoniste sélectif des récepteurs 5-hydroxytryptamine de type 3. O ndansetron is effective against chemotherapy-induced and postoperative nausea and vomiting (1,2). Over the past few years, several publications reported on the efficacy of ondansetron in treating neuraxial opioid-induced pruritus (3-5) and uremic pruritus in continuous ambulatory peritoneal dialysis (6). The current report presents a case of a child suffering from chronic pruritus refractory to conventional antipruritic drugs who was successfully treated with ondansetron. CASE PRESENTATIONA seven-year-old African-American boy weighing 21 kg was referred to the Chronic Pain Clinic at The Montreal Children's Hospital (Montreal, Quebec) with a history of disabling pruritus that was not responding to conventional treatment. The boy was born with a giant congenital melanocytic nevus with a bathing trunk distribution. The nevus was thick and was distributed from the mid-back to the buttocks with extension to the scrotum. The child had previously undergone several partial excisions of the nevus with skin grafts. Biopsies were regularly performed to evaluate the potential for malignancy. Multiple satellite nevi, that increased in number each year, covered his whole body including his face and scalp. In addition, he had three melanin-containing lesions in the brain. The brain lesions were stable and did not increase with time. The child also suffered from chronic constipation secondary to his bathing trunk nevus for which he was treated with lactulose, a colon lavage preparation (GoLYTELY, Braintree Laboratories Inc, Canada) and a high fibre diet.The patient had suffered from generalized pruritus and scratching since his first year of life. Different antipruritic treatments were tried over the years but with poor success. He was initially treated with antihistamines -hydroxyzine and diphenhydramine. Methotrimeprazine (Nozinan, sanofi aventis Canada Inc), a neuroleptic, was added to diphenhydramine for one year. Doxepin (Sinequan, ERFA Canada Inc), an antidepressant with antihistaminic properties, and ketotifen (Zaditen, PendoPharm, Canada), a noncompetitive inhibitor of histamine type 1 (H 1 ) receptors, also failed in relieving the pruritus. The pruritus did not improve with the application of local moisturizers and a topical antipruritic (Sarna P lotion,...

show abstract

Intrathecal fentanyl-induced pruritus during labour: the effect of prophylactic ondansetron

Cited by 29 publications

References 25 publications

Comparison of Percutaneous Nephrolithotomy Under Spinal Versus General Anesthesia: A Randomized Clinical Trial

Comparison of Percutaneous Nephrolithotomy Under Spinal Versus General Anesthesia: A Randomized Clinical Trial

Correlating an 11-Point Verbal Numeric Rating Scale to a 4-Point Verbal Rating Scale in the Measurement of Pruritis

Ondansetron Treatment in a Child Presenting with Chronic Intractable Pruritus

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