EFFICACY OF INTRAVENOUS ONDANSETRON ON PRURITUS AFTER INTRATHECAL OPIOID IN CESAREAN SECTION WITH SPINAL ANESTHESIA

Although intraspinal opioid has been presented to be effective in providing analgesia after cesarean delivery, pruritus as a side-effect remains a common cause of dissatisfaction. We undertook a study to assess the efficacy of ondansetron for treatment or prophylaxis of intrathecal fentanyl-induced pruritus. The role of ondansetron has been studied in preventing pruritus but the results have been contradictory.
We randomized 110 patients undergoing elective cesarean section using spinal anesthesia with Marcaine 10 mg plus fentanyl 25 µg and into a double-blinded trial to receive ondansetron 4 mg (study group) or placebo (control or placebo group) after clamping of umbilical cord. Intra and post-operative itching, nausea and vomiting, and shivering in the recovery room were registered.
Forty percent of the patients in the placebo group and 23.6% in the ondansetron group had itching intraoperative (P=0.04). The incidence of post-operative itching was 38.2%, 21.8% in placebo and ondansetron groups, respectively (P=0.04). The patients reported less intra and post-operative nausea and vomiting in the ondansetron group than in the placebo group (P=0.01). There was no difference in the incidence of shivering between two groups.
This study showed that the prophylactic ondansetron reduced itching, nausea and vomiting intra and postoperative caused by intrathecal fentanyl with marcaine