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Ondansetron for Treatment of Intrathecal Morphine-Induced Pruritus After Cesarean Delivery
  1. S. Charuluxananan, M.D.,
  2. W. Somboonviboon, M.D.,
  3. O. Kyokong, M.D. and
  4. K. Nimcharoendee, M.D.
  1. From the Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  1. Reprint requests: S. Charuluxananan, M.D., Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Rama IV Rd, Pathumwan, Bangkok 10330, Thailand.


Background and Objectives Pruritus induced by intrathecal morphine is a concern in many obstetric patients after cesarean delivery and may detract from the benefit of postoperative pain relief. This study was performed to investigate the efficacy of ondansetron (5-HT3 receptor antagonist) in treatment of pruritus following intrathecal morphine.

Methods Eighty parturients developing moderate to severe pruritus following intrathecal morphine were randomly allocated into 2 groups. One group received 4 mg ondansetron while the other group received placebo (normal saline). The improvement of pruritus and other adverse effects such as pain scores, nausea, vomiting, sedation, hallucination, and respiratory depression were determined at 30 minutes after study drugs' administration.

Results The treatment success rate was higher in the ondansetron group than in the placebo group (80% v 36%, P < .001). Among the successfully treated patients, the recurrence rates of moderate to severe pruritus within 4 hours after administration of ondansetron and placebo were 12% and 70%, respectively (P < .001). The number of patients with decreased nausea and vomiting score was also higher in the ondansetron group (11 v 1, P < .006).

Conclusion Ondansetron treats intrathecal morphine-induced pruritus after cesarean delivery, particularly in patients suffering from both nausea/vomiting and pruritus.

  • Complication
  • Intrathecal
  • Morphine
  • Pruritus
  • Ondansetron
  • Cesarean delivery

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  • Supported by a grant from the Thai Red Cross Society under patronage of HM. King Bhumibhol.