A. Borgeat et al., SUBHYPNOTIC DOSES OF PROPOFOL RELIEVE PRURITUS INDUCED BY EPIDURAL AND INTRATHECAL MORPHINE, Anesthesiology, 76(4), 1992, pp. 510-512
We investigated the efficacy of subhypnotic doses of propofol for spin
al morphine-induced pruritus in a prospective, randomized, double-blin
d, placebo-controlled study. Fifty patients, ASA physical status 1-3,
with spinal morphine-induced pruritus were allocated to receive either
1 ml propofol (10 mg) or 1 ml placebo (Intralipid) intravenously afte
r gynecologic, orthopedic, thoracic, or gastrointestinal surgery. In t
he absence of a positive response, a second drug treatment was given 5
min later. The persistence of pruritus 5 min after the second treatme
nt dose was considered a treatment failure. All failures then received
, in an open fashion, a supplementary dose of propofol (10 mg) and wer
e reevaluated 5 min later. Both groups were well matched. The success
rate was significantly greater in the propofol group (84%) than in the
placebo (16%) group (P < 0.05). Ninety percent of the treatment failu
res in the placebo group were successfully treated by a supplementary
dose of 10 mg propofol. Eight percent of the patients (4% in each grou
p) were resistant to all treatments, including naloxone 0.08 mg intrav
enously. Three patients had a slight increase in sedation in the propo
fol group versus none in control (not significant). The beneficial eff
ect of treatment was longer than 60 min in 85% of patients in the prop
ofol group and in 100% of the controls (not significant). These result
s suggest that propofol in a subhypnotic dose is an efficient drug tre
atment for spinal morphine-induced pruritus. At the dose administered
(10 mg), side effects were rare and minor.