Document Details
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Document Type |
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Article In Journal |
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Document Title |
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Treatment of intrathecal morphine-induced pruritus following caesarean section. Treatment of intrathecal morphine-induced pruritus following caesarean section. |
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Document Language |
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English |
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Abstract |
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Alhashemi JA, Crosby ET, Grodecki W, Duffy PJ, Hull KA, Gallant C.
Department of Anaesthesia, Ottawa General Hospital, University of Ottawa, Ontario.
PURPOSE: To compare both the efficacy and cost of nalbuphine and diphenhydramine in the treatment of intrathecal morphine-induced pruritus following Caesarean section. METHODS: Eighty patients, undergoing elective Caesarean section under spinal anaesthesia, were randomized, in a prospective, double-blind trial, to receive either nalbuphine (Group NAL) or diphenhydramine (Group DIP) for the treatment of SAB morphine-induced pruritus. All patients received an intrathecal injection of 10-12 mg hyperbaric bupivacaine 0.75% and 200 micrograms preservative free morphine. Postoperative pruritus was assessed, using a visual analogue scale (VAS), for 24 hr. Pruritus treatment was administered upon patient request and by a nurse blinded to the treatment given. Patients who failed to respond to three doses of the study drug were deemed treatment failures. Patient satisfaction was assessed with a questionnaire given 24 to 48 hr after surgery. Direct drug costs were calculated based on the pharmacy provision costs as of April 1996. RESULTS: Eighty patients were enrolled and 45 requested treatment for pruritus. Patients treated with NAL (n = 24) were more likely to achieve a VAS score of zero with treatment (83% vs 43%, P < 0.01), had a higher delta VAS following treatment (4 +/- 2 vs 2 +/- 2, P < 0.003), and experienced fewer treatment failures (4% vs 29%, P < 0.04), than those treated with DIP (n = 21). Group NAL patients were also more likely to rate their pruritus treatment as being good to excellent (96% vs 57%, P < 0.004). Direct drug costs were higher for NAL than for DIP ($6.4 +/- 3.1 vs $1.7 +/- 0.7, respectively, P < 0.0001). CONCLUSION: Nalbuphine is more effective than diphenhydramine in relieving pruritus caused by intrathecal morphine and the cost differences are small.
PMID: 9350364 [PubMed - indexed for MEDLINE] |
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ISSN |
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9350364 |
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Journal Name |
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Can J Anaesth |
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Volume |
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44 |
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Issue Number |
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10 |
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Publishing Year |
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1997 AH
1997 AD |
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Article Type |
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Article |
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Added Date |
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Sunday, March 21, 2010 |
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Researchers
| جمال الهاشمي | Alhashemi, Jamal | Researcher | Doctorate | |
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