J Korean Pain Soc.  1997 Nov;10(2):208-213.

Treatment of Epidural - Morphine Induced Pruritus: Propofol Versus Naloxone

• Park CH
• Jung HJ

Abstract

BACKGROUND
Pruritus is the most frequent undesirable symptom associated with epidural morphine. It is unpleasant and often difficult to treat. Naloxone is presently the drug of first choice for treating this symptom. Naloxone however decrease the pain threshold in some cases. Recently it was teported subhypnotic doses of propofol were efficient in relieving epidural-morphine-induced pruritus (EMIP). In a prospective, randomized, double-blinded clinical trial, we compared the efficacy of propofol and naloxone for treatment of EMIP.
METHODS
Forty patients with EMIP were allocated to receive either 20 mg propofol, or 1.5 p g/kg naloxone intravenously. Pruritus and level of postoperative pain were assessed after 5 min, using pruritus rating scale and visual analogue scale.
RESULTS
The overall success rate in treating pruritus was similar in both groups (propofol 70% vs naloxone 65%). Twenty-five percent of the patients in the naloxone group had an increase in the level of postopetative pain versus none in the propofol group (P=0.018).
CONCLUSIONS
These results suggest propofol and naloxone are equally effective in treating EMIP. However, the level of postoperative pain is significantly reduced when treated with propofol.

Keyword

Analgesics, morphine; Anesthetics, intravenous, propofol; Antagonist, narcotics, naloxone; Complications, pruritus

MeSH Terms

Humans
Morphine*
Naloxone*
Pain Threshold
Pain, Postoperative
Propofol*
Prospective Studies
Pruritus*
Morphine
Naloxone
Propofol