Comparación de los efectos profilácticos del droperidol y del ondansetrón sobre el prurito provocado por la morfina subaracnoidea

Fabio Ferreira da Cunha Brião , Marcio Leal Horta , Bernardo Lessa Horta , Guilherme Antônio Moreira de Barros , Ana Paula Behrensdorf , Ingrid Severo , Mariana Antunes Nunes , Roberta Boabaid , André Real
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引用次数: 1

Abstract

Background and objectives

The prophylactic effect of ondansetron on subarachnoid morphine-induced pruritus is controversial, while evidence suggests that droperidol prevents pruritus. The aim of this study is to compare the effects of droperidol and ondansetron on subarachnoid morphine-induced pruritus.

Methods

One hundred eighty patients ASA I or II patients scheduled to undergo cesarean sections under subarachnoid anesthesia combined with morphine 0.2 mg were randomized to receive, after the child's birth, metoclopramide 10 mg (Group I-control), droperidol 2.5 mg (Group II) or ondansetron 8 mg (Group III). Postoperatively, the patients were assessed for pruritus (absent, mild, moderate or severe) or other side effects by blinded investigators. Patients were also blinded to their group allocation. The tendency to present more severe forms of pruritus was compared between groups. NNT was also determined.

Results

Patients assigned to receive droperidol (proportional odds ratio: 0.45 [95% confidence interval 0.23-0.88]) reported less pruritus than those who received metoclopramide. Ondansetron effect was similar to metoclopramide (proportional odds ratio: 0.95 [95% confidence interval 0.49-1.83]). The NNT for droperidol and ondansetron was 4.0 and 14.7, respectively.

Conclusions

Ondansetron does not inhibit subarachnoid morphine-induced pruritus.

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droperidol和ondansetron对蛛网膜下腔吗啡引起的瘙痒的预防作用的比较
背景与目的昂丹西琼对蛛网膜下腔吗啡引起的瘙痒的预防作用尚存争议,而有证据表明氟哌啶醇可以预防瘙痒。本研究的目的是比较哌啶醇和昂丹西琼对蛛网膜下腔吗啡引起的瘙痒的影响。方法180例ASA I级或II级患者拟行蛛网膜下腔麻醉联合吗啡0.2 mg剖宫产术,分娩后随机给予甲氧氯普胺10 mg(对照组)、哌啶醇2.5 mg(组)或昂丹司琼8 mg(组)。术后采用盲法评估患者瘙痒(无、轻、中、重度)及其他不良反应。患者也不知道他们的分组分配。比较两组之间出现更严重形式的瘙痒的趋势。NNT也被确定。结果接受哌啶醇治疗的患者(比例优势比:0.45[95%可信区间0.23-0.88])瘙痒症状少于接受甲氧氯普胺治疗的患者。昂丹司琼效应与甲氧氯普胺相似(比例优势比:0.95[95%可信区间0.49-1.83])。氟哌啶醇和昂丹司琼的NNT分别为4.0和14.7。结论sondansetron对蛛网膜下腔吗啡性瘙痒无抑制作用。
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