Subhypnotic Doses of Propofol Relieve Pruritus Induced by Epidural and Intrathecal Morphine

The pruritus of cholestasis

“…Apparent ameliorations of the pruritus of cholestasis after the administration of propofol 36,37 may also be attributable to a modulation of opioidergic tone. 38 The available data do not indicate which endogenous opioid receptor ligands may be responsible for contributing to the pruritus or which opiate antagonists may be optimal for use in its short-term or long-term treatment. Only interactions between certain opioid peptides and certain opioid receptor subtypes may be relevant to the pruritus of cholestasis.…”

Pruritus—itching for a cause and relief?

“…Propofol has recently been advocated for relieving pruritus associated with cholestasis [52] and opioids [53] administered via epidural or spinal routes. It is used in subhypnotic doses (10 mg bolus or 0.3 pg.…”

“…Despite its proven efficacy, it can only be used on a short-term basis as it has to be given parenterally [52]. Overall, propofol has a success rate of 80% in relieving pruritus induced by epidural morphine for 3-6 h, when given as a single bolus, with the added advantage of reducing postoperative pain [53]. Serotonin type 3 receptor antagonists have been proposed for the treatment of intractable pruritus …”

Anaesthesia for daycase gynaecological laparoscopy: a survey of clinical practice in the United Kingdom

“…ondansetron) have also been used with some efficacy in pruritus [31]. Most recently subhypnotic doses of propofol (0.3 mg. kg À1 .min À1 ) have been advocated for pruritus following the use of epidural opioids, but the use of a propofol infusion requires constant supervision [32]. Propofol is believed to act by inhibition of ventral and dorsal spinal roots.…”