The Effect of Nanomolar Celecoxib on Reducing Intrathecal Meperidine-induced Pruritus

Background and Use of intrathecal opioids causes an increase in the block depth of anesthetics and duration of analgesia. Intrathecal opioids are associated with side effects such as itching, nausea and vomiting. However, the use of NSAIDs reduces itching induced by intrathecal opioids. Therefore, the present study intends to determine and compare the effects of nanogram celecoxib on reducing the incidence and intensity of intrathecal meperidine-induced pruritus. Methods and Materials: This double-blind clinical trial was conducted on 90 patients undergoing caesarean section. Patients were randomly assigned into experimental and control groups. The experimental group received 25ng/kg or 100ng/kg celecoxib and the control group received oral placebo. Patients under spinal anesthesia received meperidine 10mg with intrathecal Bupivacaine 0.5%. Then, pruritus was assessed 0, 2, 6, 12 and 24 hours after surgery, and were recorded by scoring criteria. The obtained data were analyzed in SPSS using one-way ANOVA, chi-square and Fisher’s exact test. Values below 5% were considered significant. The difference of the two groups in their age, weight and oral intake was not significant (confidence interval 95%). The incidence of itching in the experimental groups of 25ng/kg (p=0.049) or 100ng/kg celecoxib (p=0.001) in 0 and 2 hours after surgery were significantly lower than the control group; also, the intensity of itching 2 hours after surgery was significantly lower then the control group (p=0.001). Nanogram doses of Celecoxib can be used for reducing the incidence and intensity of meperidine induced pruritus.