Table 2.
Prophylactic Use: Administration After Administration of Spinal Morphine but Before Occurrence of Pruritis
| Medication Group | No. of Studies | Used Medication from Groupa | Administration Medicationa | Compared toa | Effectiveness | |
|---|---|---|---|---|---|---|
| Pruritus Preventiona, b | Pruritus Severitya, b | |||||
| 5HT-3 Antagonist | 9 | Ondansetron: 9 Granisetron: 2 Tropisetron: 1 |
Intravenous: 9 | Control: 8 Medication: 5 |
Superior: 2 (n.a. 1) Specifications: vs con/vs med: 2/1 IV: 2 |
Superior: 2 (n.a. 1) Specifications: vs con/vs med: 1/1 IV: 2 |
| Opioid antagonist | 12 | Naloxone: 8 Naltrexone:2 Methylnaltrexone: 1 Nalmefene: 2 |
Intravenous: 6 PCA: 1 Epidural: 1 Per os: 2 Subcutaneous: 2 |
Control: 12 Medication: 1 |
Superior: 7 (n.a. 1) Specifications: vs con/vs med: 7/0 IV/PCA/epi/PO/SC: 4/ n.a/ 1/ 2/ 0 |
Superior: 4 (n.a. 3) Specifications: vs con/vs med: 4/0 IV/ PCA/ epi/ PO/ SC: 1/ 1/ 1/ 0/ 1 |
| Opioid agonist/antagonists | 9 | Nalbuphine: 7 Pentazocine 1 Butorphanol: 1 |
Intravenous: 7 PCA: 1 Intramuscular: 1 |
Control: 8 Medication: 2 |
Superior: 6 (n.a. 1) Specifications: vs con/vs med: 6/1 IV/ PCA/ IM: 5/ n.a./ 1 |
Superior: 8 (n.a. 0) Specifications: vs con/vs med: 7/2 IV/ PCA/ IM: 6/ 1/ 1 |
| Antihistamines | 4 | Diphenhydramine: 2 Promethazine: 1 Hydroxyzine: 1 |
Intravenous: 2 Intramuscular: 2 |
Control: 4 Medication: 2: |
Superior: 0 (n.a. 0) |
Superior: 1 (n.a. 1) Specifications: vs con: 1 IM: 1 |
| Dopamine antagonists | 6 | Droperidol: 5 Alizapride: 2 |
Intravenous: 6 Epidural: 1 |
Control: 6 Medication: 1 |
Superior: 4 (n.a. 0) Specifications: vs con/vs med: 4/0 IV/epi: 3/1 |
Superior: 5 (n.a. 1) Specifications: vs con/vs med: 5/1 IV/epi: 4/1 |
| NMDA-receptor antagonists | 1 | Ketamine: 1 | Intravenous: 1 | Control: 1 Medication: 0 |
Superior: 1 (n.a. 0) Specifications: vs con: 1 IV: 1 |
Superior: 1 (n.a. 0) Specifications: vs con: 1 IV: 1 |
| NSAID’s | 4 | Celecoxib: 1 Valdecoxib: 1 Tenoxicam: 1 Diclofenac: 1 |
Intravenous: 1 Per os: 2 Rectal: 1 |
Control: 4 Medication: 0 |
Superior: 0 (n.a. 1) | Superior: 0 (n.a. 2) |
| Propofol | 3 | Propofol: 3 | Intravenous: 3 | Control: 3 Medication: 1 |
Superior: 2 (n.a. 0) Specifications: vs con/vs med: 2/1 IV: 3 |
Superior: 1 (n.a. 2) Specifications: vs con/vs med: 1/1 IV: 1 |
| Other study treatments | 1 | Acupuncture: 1 | In anesthesia area (AA): 1 Not anesthesia area (NAA): 1 |
Control: 1 Treatment: 1 |
Superior: 1 (n.a. 0) Specifications: vs con: 1 AA (vs NAA): 1 |
Superior: 0 (n.a. 1) |
Notes: aStudies that fall in multiple categories are mentioned multiple times, ie for studies comparing the same medication with different administration, or studies comparing two medicaments of the same group. bOverview and specifications of studies showing effectiveness. Not all studies provided information on both prevention and severity of pruritus, indicated by n.a. Overview of study results assessing the prophylactic effectiveness of study medication administered after morphine, but before occurrence of pruritus. Values are presented as n=number of studies.
Abbreviations: vs con, comparison between study medication and control (placebo or nothing); vs med, comparison between two different study medications; IV, intravenous; PCA, patient-controlled anesthesia; IT, intrathecal; epi, epidural; PO, per os; n.a, not available.