British Journal of Anaesthesia, Vol 82, Issue 3 439-441, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
K. Kyriakides, S. K. Hussain and G. J. Hobbs
We have evaluated the efficacy of ondansetron in the prevention of
opioid-induced pruritus in a prospective, randomized, double-blind,
placebo-controlled study. Using a 'human model' of opioid-induced pruritus,
80 ASA I-II patients about to undergo routine surgery were given either
ondansetron 4 mg i.v. or 0.9% saline i.v. (40 in each group), 30 min before
alfentanil 10 mg kg-1 i.v. During the following 5 min, patients were
observed for signs of perinasal scratching and at 5 min were asked about
symptoms of pruritus. The study was then terminated and anaesthesia was
induced. There was a significant reduction in the incidence of scratching
in patients receiving ondansetron compared with placebo (42.5% vs 70%,
respectively, P = 0.013). The incidence of itching in the ondansetron group
was less than that in the placebo group but this was not statistically
significant (30% vs 42.5%, respectively, P = 0.245). We conclude that the
5-HT3 antagonist ondansetron may have a role in the management of opioid-
induced pruritus.
SHORT COMMUNICATIONS
Management of opioid-induced pruritus: a role for 5-HT3 antagonists?
University Department of Anaesthesia, Queen's Medical Centre, University Boulevarde, Nottingham NG7 2UH, UK
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