Ondansetron and Metoclopramide Can Prevent Intrathecal Sufentanil-Induced Pruritus

Abstract

Background: We have compared the effectiveness of metoclopramide and ondansetron in the prevention of pruritus caused by intrathecal injection of sufentanil in parturients undergoing elective caesarean section under spinal anesthesia.
Methods: 123 parturients ASA I & II divided in to 3 groups with random allocation software, with 41 parturient in each group. Spinal anesthesia was performed with 2 ml of bupivacaine 0.5% plus 2.5 microgram sufentanil.
The first group received 4mg of ondansetron, the second group 10mg of metoclopramide and the third group placebo, immediately after clamping of the umbilical cord. During surgery and postoperative period, the parturients were assessed for hemodynamic changes, pruritus, nausea and vomiting and shivering.
Results: There were significant differences in the incidence of pruritus among three groups. The incidence of moderate pruritus was significantly higher in control group (47.5%) in comparison with ondansetron (15.8%) and metoclopramide (10%)groups. Severe pruritus was significantly higher in the control group (15%).The incidence of shivering was significantly lower in metoclopramide group (37.5% in comparison with 89.5% and 72.5% in the ondansetron and control groups). Moreover, the incidence of nausea and vomiting was significantly higher in placebo group.
Conclusion: Ondansetron and metoclopramide can effectively prevent and reduce the severity and the incidence of intrathecal sufentanil induced pruritus. Both drugs can reduce the incidence of nausea and vomiting. Metoclopramide also reduces shivering in this study.