EPIDURAL-MORPHINE-INDUCED PRURITUS - PROPOFOL VERSUS NALOXONE

In a prospective, randomized, double-blind clinical trial, we compared the efficacy of propofol and naloxone for the treatment of spinal-mor phine-induced pruritus. Forty patients presenting with severe pruritus within 24 h of epidural morphine administration were allocated to rec eive either propofol 10 mg intravenously (IV) or naloxone 2 mu g/kg. I n the absence of a positive response, a second dose of the same treatm ent was given 5 min later. Pruritus and the level of postoperative pai n were assessed every 5 min up to the end of the study period (45 min) using a verbal rating scale. The overall success rate in treating pru ritus was similar in the two groups (80%). The rate of success after t he first injection of the treatment drug was also similar (55%). The l evel of postoperative pain decreased after drug treatment in six patie nts (30%) in the propofol group versus none in the naloxone group (P < 0.05). Forty-five percent of the patients in the naloxone group had a n increase in the level of postoperative pain versus none in the propo fol group (P < 0.05). In conclusion, these results suggest that propof ol and naloxone are equally effective in treating spinal-morphine-indu ced pruritus. However, the level of postoperative pain is significantl y less in the propofol group.