Table 2.
Summary of clinical studies evaluating the effectiveness of opioid receptor partial agonists in managing neuraxial opioid-induced pruritus in adult patients
| Neuraxial opioids |
Treatment drugs and doses | Outcomes and conclusion | References |
|---|---|---|---|
| Epidural morphine 0.1 mg/kg | Intravenous nalbuphine 0.1 mg/kg | Effective Pruritus score: ↓ | Penning et al. (1988) |
| Epidural morphine 5 mg | Intravenous nalbuphine 20 mg | Ineffective No change in the degree of pruritus | Morgan et al. (1991) |
| Epidural morphine 5 mg | Intravenous nalbuphine 5 mg | Effective Severity of pruritus: ↓ | Cohen et al. (1992) |
| Epidural morphine 5 mg | Intravenous nalbuphine 2.5 mg/h | Effective Pruritus score: ↓ | Kendrick et al. (1996) |
| Epidural morphine 3 mg/12 h | Intravenous nalbuphine 60 µg/kg/h | Effective Incidence of pruritus (13 %): ↓ | Wang et al. (1998) |
| Epidural morphine 1.5 mg/12 h | Intramuscular nalbuphine 10 mg | Effective Incidence of pruritus (44 %): ↓ Severity of pruritus: ↓ | Liao et al. (2011) |
| Intrathecal morphine 200 µg | Nalbuphine (no specified delivery route) 5–10–10 mg, stepwise | Effective VAS score of zero (83 %) | Alhashemi et al. (1997) |
| Intrathecal morphine 200 µg | Intravenous nalbuphine 3 mg | Effective Treatment success rate (83 %): ↑ | Charuluxananan et al. (2001) |
| Intrathecal morphine 200 µg | Intravenous nalbuphine 4 mg | Effective Pruritus score: ↓ Request for pruritus treatment: ↓ | Charuluxananan et al. (2003) |
| Intrathecal morphine 150 µg | Intravenous nalbuphine 2–3 mg | Effective % of successful treatment (87–97 %): ↑ | Somrat et al. (1999) |
| Intrathecal fentanyl 50 µg | Intravenous nalbuphine 4 mg | Partially effective Incidence of pruritus (61 %) | Ben-David et al. (2002) |
| Epidural morphine 4 mg | Epidural butorphanol 3 mg | Effective % patients treated for pruritus (0 %): ↓ | Lawhorn et al. (1991) |
| Epidural morphine 4 mg | Epidural butorphanol 3 mg | Effective Incidence of pruritus (20 %): ↓ | Wittels et al. (1993) |
| Epidural morphine 3 mg | Epidural butorphanol 3 mg | Ineffective No change in VAS for pruritus | Gambling et al. (1994) |
| Epidural morphine 60 µg/kg | Epidural butorphanol 30 µg/kg | Effective Severity of pruritus: ↓ | Bailey et al. (1994) |
| Intrathecal morphine 150 µg | Intravenous butorphanol 2 mg | Ineffective No change in the intensity of pruritus | Sakai et al. (2001) |
| Intrathecal morphine 100 µg | Intravenous butorphanol Bolus 1 mg with 0.2 mg/h | Effective Incidence of pruritus (13 %): ↓ | Wu et al. (2012) |
Note: VAS visual analog scale, ↓ = decrease/inhibition, ↑ = increase