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.