Prophylactic ondansetron does not reduce the incidence of itching induced by intrathecal sufentanil

  • Beverly Waxler
  • Shirley A. Mondragon
  • Sonal N. Patel
  • Kochuthresia Nedumgottil
Regional Anesthesia and Pain



Postoperative itching after intrathecal (IT) narcotics may be a difficult and important problem for both the anesthesiologist and the patient in the postanesthetic care unit. Since some studies have reported success in preventing itching with ondansetron, we designed a prospective, randomized, double-blinded, and controlled study to test whether prophylactic iv ondansetron effectively reduces the incidence of IT sufentanil-induced pruritus.


Thirty-four patients (ASA I-III, age 18–74 yr) underwent ambulatory surgery after spinal anesthesia with IT lidocaine (15-100 mg) and IT sufentanil (10 μg). The patients were randomized into two groups to receiveiv either 4 mL saline (n = 13) or 8 mg ondansetron (n = 21) before the IT injection. The incidence of pruritus and other variables was recorded. Pruritus scores were obtained with a verbal analogue score with 0 meaning none and 10 the worst itching that the patient could imagine. Statistical difference was assumed if P < 0.05.


Ondansetron did not reduce the incidence of pruritus (77vs 81%) compared to placebo (P = 1.000). The pruritus scores (4.4 vs 3.6) of the two groups were not significantly different (P =0.670).


There are contradictory findings in the literature regarding the effectiveness of ondansetron in preventing narcotic-induced itching. Although some studies have indicated that ondansetron could prevent this side effect of IT narcotics, a recent report suggested that ondansetron is not effective in preventing narcotic-induced itching (sufentanil-morphine) after a Cesarean section. In the present study we obtained similar, negative results.

L’administration prophylactique d’ondansétron ne réduit pas l’incidence de prurit induit par le sufentanil intrathécal



Le prurit postopératoire induit par l’administration intrathécaie (IT) de narcotiques est un problème important pour l’anesthésiologiste et le patient en salle de réveil. Certaines études ont montré que l’ondansétron prévenait le prurit. Notre étude prospective, randomisée, contrôlée et à double insu voulait vérifier si l’administration iv préventive d’ondansétron réduit effectivement l’incidence de prurit induit par le sufentanil IT.


Trentequatre patients (ASA I–III, de 18 à 74 ans) ont subi une intervention chirurgicale ambulatoire sous rachianesthésie avec de la lidocaïne IT(15–100 mg) et du sufentanil IT(10μg). Lespatients, randomisée en deux groupes, ont reçu soit 4 mL de solution saline iv (n = 13), soit 8 mg d’ondansétron (n =21) avant l’injection IT L’incidence de prurit et d’autres variables a été notée. Les scores de prurit ont été obtenus par une échelle verbale analogique où 0 n’indiquait aucun prurit et 10, le pire prurit imaginable. On supposait une différence statistique si P < 0,05.


Londansétron, comparé au placebo, n’a pas réduit l’incidence de prurit (77 vs 81 %, P = 1,000). Le prurit (4,4 vs 3,6) des patients des deux groupes n’était pas significativement différent (P =0,670).


Des résultats contradictoires découlent de publications sur l’efficacité de l’ondansétron dans la prévention du prurit induit par les narcotiques. Certaines études ont indiqué que l’ondansétron pouvait prévenir cet effet secondaire des narcotiques IT, mais un article récent montre qu’il n’est pas efficace (avec sufentanilmorphine) après une césarienne. Nos résultats négatifs sont similaires.


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Copyright information

© Canadian Anesthesiologists 2004

Authors and Affiliations

  • Beverly Waxler
    • 1
  • Shirley A. Mondragon
    • 1
  • Sonal N. Patel
    • 1
  • Kochuthresia Nedumgottil
    • 1
  1. 1.Division of Postanesthesia Care, Department of Anesthesiology and Pain ManagementJohn H. Stroger Jr. Hospital of Cook CountyChicagoUSA

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