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Ondansetron is as effective as diphenhydramine for treatment of morphine-induced pruritus after cesarean delivery

Show simple item record Siddik-Sayyid S.M. Yazbeck-Karam V.G. Zahreddine B.W. Adham A.M.B.F. Dagher C.M. Saasouh W.A. Aouad M.T.
dc.contributor.editor Jul-2010 2017-10-05T15:29:08Z 2017-10-05T15:29:08Z 2010
dc.identifier 10.1111/j.1399-6576.2010.02231.x
dc.identifier.issn 00015172
dc.description.abstract Background: Subarachnoid (SA) morphine, highly effective for the management of pain after a cesarean delivery, is associated with a significant incidence of pruritus in up to 80percent of patients. No previous study has compared the effectiveness of ondansetron (5-HT3 antagonist) vs. diphenhydramine (H1 receptor blocker) for the treatment of this side effect. Methods: In this randomized, double-blind study, 113 patients with a pruritus score 3 or 4 (1=absent; 2=mild, no treatment required; 3=moderate pruritus, treatment required; and 4=severe pruritus) after SA morphine 0.2 mg were assigned to group ondansetron, which received 4 mg intravenously (i.v.) ondansetron, and group diphenhydramine, which received 25 mg i.v. diphenhydramine. Patients who continued to have pruritus ≥3 30 min after the study drug were considered treatment failures and were treated with naloxone 0.04 mg i.v. repeatedly, as well as patients who relapsed. Pain scores, nausea, vomiting, and sedation were determined before and 30 min after the study drugs were administered. Patients were followed up for 24 h. Results: The success rate was comparable between the two groups [40-57 (70percent) and 38-56 (70percent), P=0.79, in group ondansetron and group diphenhydramine, respectively]. Among the successfully treated patients, the recurrence rates of moderate to severe pruritus were 11-40 (28percent) in group ondansetron and 13-38 (35percent) in group diphenhydramine, P=0.52. The side effect profile was similar between the two groups. Conclusion: Ondansetron is as effective as diphenhydramine in relieving pruritus caused by SA morphine in patients undergoing a cesarean delivery. However, up to 50percent of patients required naloxone either for primary failure or for recurrence. © 2010 The Authors.
dc.format.extent Pages: (764-769)
dc.language English
dc.publisher MALDEN
dc.relation.ispartof Publication Name: Acta Anaesthesiologica Scandinavica; Publication Year: 2010; Volume: 54; no. 6; Pages: (764-769);
dc.source Scopus
dc.title Ondansetron is as effective as diphenhydramine for treatment of morphine-induced pruritus after cesarean delivery
dc.type Article
dc.contributor.affiliation Siddik-Sayyid, S.M., Department of Anesthesiology, American University of Beirut, Medical Center, Beirut, Lebanon
dc.contributor.affiliation Yazbeck-Karam, V.G., Department of Anesthesiology, Rizk Hospital, Beirut, Lebanon
dc.contributor.affiliation Zahreddine, B.W., Department of Anesthesiology, American University of Beirut, Medical Center, Beirut, Lebanon
dc.contributor.affiliation Adham, A.M.B.F., Department of Anesthesiology, American University of Beirut, Medical Center, Beirut, Lebanon
dc.contributor.affiliation Dagher, C.M., Department of Anesthesiology, American University of Beirut, Medical Center, Beirut, Lebanon
dc.contributor.affiliation Saasouh, W.A., Department of Anesthesiology, American University of Beirut, Medical Center, Beirut, Lebanon
dc.contributor.affiliation Aouad, M.T., Department of Anesthesiology, American University of Beirut, Medical Center, Beirut, Lebanon
dc.contributor.authorAddress Aouad, M. T.; Department of Anesthesiology, American University of Beirut, PO Box 11-0236, Beirut, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Anesthesiology;
dc.contributor.authorDepartment Anesthesiology
dc.contributor.faculty Faculty of Medicine
dc.contributor.authorInitials Siddik-Sayyid, SM
dc.contributor.authorInitials Yazbeck-Karam, VG
dc.contributor.authorInitials Zahreddine, BW
dc.contributor.authorInitials Adham, AMBF
dc.contributor.authorInitials Dagher, CM
dc.contributor.authorInitials Saasouh, WA
dc.contributor.authorInitials Aouad, MT
dc.contributor.authorReprintAddress Aouad, MT (reprint author), Amer Univ Beirut, Dept Anesthesiol, Med Ctr, POB 11-0236, Beirut, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 4
dc.description.citedTotWOSCount 4
dc.description.citedWOSCount 4
dc.format.extentCount 6
dc.identifier.coden AANEA
dc.identifier.pubmedID 20236094
dc.identifier.scopusID 77953159985
dc.publisher.address COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA
dc.relation.ispartOfISOAbbr Acta Anaesthesiol. Scand.
dc.relation.ispartOfIssue 6
dc.relation.ispartofPubTitle Acta Anaesthesiologica Scandinavica
dc.relation.ispartofPubTitleAbbr Acta Anaesthesiol. Scand.
dc.relation.ispartOfVolume 54
dc.source.ID WOS:000278292400015
dc.type.publication Journal
dc.subject.otherChemCAS diphenhydramine, 147-24-0, 58-73-1
dc.subject.otherChemCAS morphine, 52-26-6, 57-27-2
dc.subject.otherChemCAS naloxone, 357-08-4, 465-65-6
dc.subject.otherChemCAS ondansetron, 103639-04-9, 116002-70-1, 99614-01-4
dc.subject.otherChemCAS Diphenhydramine, 58-73-1
dc.subject.otherChemCAS Histamine H1 Antagonists
dc.subject.otherChemCAS Morphine, 57-27-2
dc.subject.otherChemCAS Naloxone, 465-65-6
dc.subject.otherChemCAS Narcotic Antagonists
dc.subject.otherChemCAS Narcotics
dc.subject.otherChemCAS Ondansetron, 99614-02-5
dc.subject.otherChemCAS Serotonin Antagonists
dc.subject.otherIndex diphenhydramine
dc.subject.otherIndex morphine
dc.subject.otherIndex naloxone
dc.subject.otherIndex ondansetron
dc.subject.otherIndex adult
dc.subject.otherIndex article
dc.subject.otherIndex cesarean section
dc.subject.otherIndex clinical trial
dc.subject.otherIndex controlled clinical trial
dc.subject.otherIndex controlled study
dc.subject.otherIndex double blind procedure
dc.subject.otherIndex drug efficacy
dc.subject.otherIndex drug safety
dc.subject.otherIndex female
dc.subject.otherIndex follow up
dc.subject.otherIndex human
dc.subject.otherIndex major clinical study
dc.subject.otherIndex nausea and vomiting
dc.subject.otherIndex pain assessment
dc.subject.otherIndex patient satisfaction
dc.subject.otherIndex priority journal
dc.subject.otherIndex pruritus
dc.subject.otherIndex randomized controlled trial
dc.subject.otherIndex recurrence risk
dc.subject.otherIndex sedation
dc.subject.otherIndex Adult
dc.subject.otherIndex Cesarean Section
dc.subject.otherIndex Diphenhydramine
dc.subject.otherIndex Double-Blind Method
dc.subject.otherIndex Female
dc.subject.otherIndex Histamine H1 Antagonists
dc.subject.otherIndex Humans
dc.subject.otherIndex Morphine
dc.subject.otherIndex Naloxone
dc.subject.otherIndex Narcotic Antagonists
dc.subject.otherIndex Narcotics
dc.subject.otherIndex Ondansetron
dc.subject.otherIndex Pain, Postoperative
dc.subject.otherIndex Patient Satisfaction
dc.subject.otherIndex Postoperative Nausea and Vomiting
dc.subject.otherIndex Pregnancy
dc.subject.otherIndex Pruritus
dc.subject.otherIndex Recurrence
dc.subject.otherIndex Serotonin Antagonists
dc.subject.otherIndex Severity of Illness Index
dc.subject.otherKeywordPlus OPIOID-INDUCED PRURITUS
dc.subject.otherKeywordPlus INTRATHECAL MORPHINE
dc.subject.otherKeywordPlus EPIDURAL-MORPHINE
dc.subject.otherKeywordPlus POSTCESAREAN ANALGESIA
dc.subject.otherKeywordPlus PREVENTION
dc.subject.otherKeywordPlus NALOXONE
dc.subject.otherKeywordPlus SECTION
dc.subject.otherKeywordPlus NALBUPHINE
dc.subject.otherKeywordPlus PROPOFOL
dc.subject.otherKeywordPlus NAUSEA
dc.subject.otherWOS Anesthesiology

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