A Comparison of the Effect of Ondansetron and Propofol on Intrathecal Opioid-Induced itch in Elective Cesarean Section

Abstract

J Babol Univ Med Sci; 20(2); Feb 2018; PP: 7-12 Received: Jun 12 2017, Revised: Sep 23 2017, Accepted: Dec 2 2017. ABSTRACT BACKGROUND AND OBJECTIVE: Itch is one of the most common and uncomfortable side effects of neuraxial anesthesia. Its incidence is higher especially in cesarean section. The aim of this study was to compare the effect of ondansetron and propofol at doses lower than the hypnotic dose on the treatment of itch induced by intrathecal fentanyl in cesarean section. METHODS: In this prospective study, 90 patients with American Society of Anesthesiologists (ASA) class I and class II with an average age of 30 years and first time cesarean section underwent intra-spinal anesthesia with 25 μg fentanyl and 10 mg bupivacaine 0.5%. Women were randomly divided into two groups of 45. One group received 4 mg ondansetron and another group received 10 mg propofol at first and then 10 μg/kg / min through infusion. The incidence and severity of itch were recorded on the basis of the visual scoring system during operation and during recovery. FINDINGS:The highest incidence of itch was 30 to 60 minutes after injection. The incidence of itch during surgery was 2.22% and 7.26%, and during recovery was 7.6% and 8.8%, in the ondansetron and propofol groups, respectively (p=0.5, p=0.4). The mean itch severity scores during surgery were 1.85±0.69 and 1.66±0.81, and during the recovery were 1.33±0.57 and 1.25±0.5, in the ondansetron and propofol groups, respectively (p=0.65) (p=0.84). CONCLUSION: Based on the results of this study, ondansetron and propofol at doses lower than the hypnotic dose were well tolerated. Considering the effect of both drugs on the treatment of itch caused by intrathecal fentanyl, both of them can be used clinically.