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REGIONAL ANESTHESIA

Prophylactic Ondansetron Reduces the Incidence of Intrathecal Fentanyl-Induced Pruritus

Kocaeli University School of Medicine, Department of Anesthesiology and Reanimation, Kocaeli, Turkey

Address correspondence and reprint requests to Dr. Yavuz Gürkan, Kalamis, Erguvan Sok. Kucukgul Apt. No. 17/6, Kadikoy, Istanbul, 81030, Turkey. Address e-mail to yavuzg{at}superonline.com

We investigated the effectiveness of prophylactic IV ondansetron in preventing intrathecal fentanyl-induced pruritus. One-hundred-fifty ASA status I–II patients undergoing spinal anesthesia with 7–10 mg of hyperbaric bupivacaine and 25 µg of fentanyl were randomized to receive ondansetron 8 mg IV or normal saline IV before the commencement of spinal anesthesia. Evaluations were performed every 15 min in the first hour after the injection of study drugs and at 1, 2, 3, 4, 5, and 6 h after the administration of the study drug. Statistical analysis was performed by using ² tests and Student’s t-test, as appropriate. The incidence of pruritus was significantly more frequent in the placebo group compared with the ondansetron group (68% versus 39%) (P = 0.001). Time to pruritus was similar in both groups (placebo group, 55 ± 32 min versus ondansetron group, 50 ± 31 min). Duration of pruritus was also similar in both groups (placebo group, 98 ± 60 min versus ondansetron group, 103 ± 58 min). Ondansetron prophylaxis significantly reduced the incidence of intrathecal fentanyl-induced pruritus in patients undergoing surgery under bupivacaine spinal anesthesia.

IMPLICATIONS: Pruritus is a commonly reported side effect after intrathecal fentanyl administration during spinal anesthesia. This study was performed in a prospective, randomized, double-blinded, placebo-controlled manner to investigate the efficacy of prophylactic IV ondansetron in the prevention of pruritus after intrathecal fentanyl administration during spinal anesthesia. The incidence of pruritus was significantly more frequent in the placebo group compared with the ondansetron group (68% versus 39%) (P = 0.001).

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