Table 3.
Summary of clinical studies evaluating the effectiveness of a 5-HT3 receptor antagonist, ondansetron, in managing neuraxial opioid-induced pruritus in adult patients
| Neuraxial opioids | Treatment drug and doses |
Outcomes and conclusion | References |
|---|---|---|---|
| Epidural morphine, 2 mg Intrathecal morphine, 0.2 mg | Intravenous ondansetron 8 mg | Effective Success rate (70 %): ↑ | Borgeat and Stirnemann (1999) |
| Epidural morphine 3 mg | Intravenous ondansetron 4 mg | Effective Incidence of pruritus (28 %): ↓ | Tzeng et al. (2003) |
| Intrathecal sufentanil 2.5 µg and morphine 100 µg | Intravenous ondansetron 8 mg | Ineffective No change in the frequency and severity of pruritus | Yazigi et al. (2002) |
| Intrathecal morphine 160 µg and fentanyl 15 µg | Intravenous ondansetron 8 mg | Ineffective No change in the incidence of pruritus | Sarvela et al. (2006) |
| Intrathecal morphine 250 µg | Intravenous ondansetron 4 mg | Effective Incidence of pruritus (34 %): ↓ | Iatrou et al. (2005) |
| Intrathecal morphine 200 µg | Intravenous ondansetron 4–8 mg | Effective Request for pruritus treatment: ↓ | Charuluxananan et al. (2003) |
| Intrathecal morphine 200 µg | Intravenous ondansetron 4 mg | Effective Treatment success rate (80 %): ↑ | Charuluxananan et al. (2000) |
| Intrathecal morphine 200 µg | Intravenous ondansetron 4 mg Orally disintegrating tablets 8 mg | Effective Incidence of pruritus (56–66 %): ↓ | Pirat et al. (2005) |
| Intrathecal morphine 150 µg | Intravenous ondansetron 0.1 mg/kg | Effective Incidence of pruritus (25 %): ↓ | Yeh et al. (2000) |
| Intrathecal fentanyl 25 µg | Intravenous ondansetron 4–8 mg | Ineffective No change in the incidence and severity of pruritus | Wells et al. (2004) |
| Intrathecal fentanyl 25 µg | Intravenous ondansetron 8 mg | Effective Incidence of pruritus (39 %): ↓ | Gurkan and Toker (2002) |
| Intrathecal fentanyl 25 µg | Intravenous ondansetron 8 mg | Effective Incidence of pruritus (6 %): ↓ | Gulhas et al. (2007) |
| Intrathecal fentanyl 15 µg | Intravenous ondansetron 8 mg | Ineffective No change in the incidence of pruritus | Browning et al. (2013) |
| Intrathecal fentanyl 10 µg | Intravenous ondansetron 4–8 mg | Ineffective No change in the incidence and severity of pruritus | Korhonen et al. (2003) |
| Intrathecal sufentanil 10 µg | Intravenous ondansetron 8 mg | Ineffective No change in the incidence and severity of pruritus | Waxler et al. (2004) |
Note: VAS visual analog scale, ↓ = decrease/inhibition, ↑ = increase