Anesthesia & Analgesia, Vol 86, 310-313, Copyright © 1998 by International Anesthesia Research Society
Subhypnotic doses of propofol do not relieve pruritus induced by intrathecal morphine after cesarean section
Y Beilin, HH Bernstein, B Zucker-Pinchoff, J Zahn and WJ Zenzen
Department of Anesthesiology, Mount Sinai School of Medicine, New York, New York 10029-6574, USA. ybeilin@smtplink.mssm.edu
The purpose of this study was to determine whether subhypnotic doses of
propofol effectively relieve pruritus in women who received intrathecal
morphine for postoperative analgesia after cesarean delivery. Twenty- nine
women who developed pruritus after undergoing an elective cesarean section
and receiving intrathecal morphine (0.25 mg) for postoperative analgesia
were enrolled in this randomized, prospective, double-blind study. The
women were randomly assigned to receive either 1 mL of propofol (n = 17) or
1 mL of placebo (n = 12) I.V. Pruritus was evaluated 5 min after treatment.
In the absence of successful treatment, the women received another 1 mL of
the same drug. Pruritus was again evaluated 5 min after the second dose. We
found that pruritus was successfully treated twice in the propofol group
and once in the placebo group (P = not significant). The antipruritic
action of propofol lasted for up to 6 h in one woman and 15 min in the
other. The one success in the placebo group lasted for 15 min. We conclude
that the success rate of propofol in treating pruritus in women who
received intrathecal morphine for postoperative analgesia after cesarean
delivery is not significantly different from that of placebo. Implications:
Pruritus is a common and bothersome side effect of neuraxial opioids after
cesarean section. Subhypnotic doses of I.V. propofol (10 mg) have been used
to treat pruritus caused by neuraxial opioids. In this prospective,
randomized, double-blind study, we found that propofol does not relieve
pruritus in women who underwent cesarean section and received intrathecal
morphine sulfate (0.25 mg) for postoperative pain relief.