Preemptive Antiemesis using Intravenous Ondansetron to Control Intrathecal Morphine Induced Nausea and Vomiting
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 2
Abstract
Morphine is an opioid and its intrathecal use for postoperative pain relief is well documented. Nausea and vomiting are the common adverse effects with intrathecal morphine and might be distressing in patients undergoing abdominal surgeries limiting its usage. Ondansetron is helpful in treating of nausea and vomiting but would be of greater help when administered pre-emptively. Aims and Objectives: Primary aim of study was to study the effect of pre-emptive ondansetron in controlling intrathecal morphine induced nausea and vomiting. Secondary aims was to assess its effectiveness in controlling pruritus. Methods and Materials: In this prospective, randomized study ninety patients undergoing abdominal hysterectomy were categorized into 3 equal groups receiving 15mg hyperbaric Inj.bupivacaine, in addition 0.5ml saline in Group-I, and 100µg and 200µg of intrathecal morphine diluted to 0.5ml respectively in Group-II and Group-III. All patients received 4mg of Inj.ondansetron intravenously 10 minutes before administering spinal drug preparation. Patients were assessed for duration of analgesia, nausea, vomiting, pruritus and other adverse effects of intrathecal morphine. Results: There was statistical significant difference with respect to age, body mass index and duration of surgery between three groups. Intrathecal morphine resulted in significantly longer duration of analgesia in patients receiving intrathecal morphine (p<0.001). Pre-emptive ondansetron effectively controlled intrathecal morphine induced nausea (p=0.809) and vomiting (p=0.199) and it was statistically insignificant when compared to control group, but did not decrease incidence of pruritus (p=0.027). Conclusion: Pre-emptive intravenous Inj.ondansetron (4mg) effectively controls intrathecal morphine induced nausea and vomiting but not pruritus.
Authors and Affiliations
Pradeep Hosagoudar
Intra-Operative Efficacy of General Anaesthesia vs General Anaesthesia with Paediatric Epidural Anaesthesia: A Clinical Comparative Study
Paediatric epidural anaesthesia (PEA) is very safe and effective and in combination withGeneral anaesthesia (GA) offers the advantages of reduced GA drugs, stable haemodynamics and excellent analgesia extended into the p...
Awake Fiberoptic Intubation with Two Different Techniques of Local Anaesthetic Administration (Transtracheal Injection Versus Ultrasonic Nebulization) in Patients Undergoing Maxillofacial Surgery
Background and Aims: Awake fiberoptic intubation (AFOI) is considered the gold standard for anticipated difficult intubation in maxillofacial surgery. Regional anaesthesia of the airway is essential for awake fiberoptic...
Safety and Efficacy of Dexmedetomidine as an Adjuvant to Hyperbaric Bupivacaine: A Randomised Double-Blind Controlled Study
Background: Various adjuvants are co-administrated with local anaesthetic agent to improve the speed of onset of block, duration of analgesia and can decrease the dose of local anaesthetic agent. As the dose of local ana...
Real-time Ultrasound-guided Catheterisation of the Internal Jugular Vein: A Prospective Comparison with the Landmark Technique
Central venous access has become a mandatory part for clinical management of critically ill patients, both in acute care setting and chronic long term care. However, anatomical landmark guided technique for IJV cannualat...
A Comparative Study of Low Doses of Intrathecal Ketamine and Midazolam with Bupivacaine for Infraumbilical Surgeries
Aim: The aim of this study is to evaluate the effect of the low doses of ketamine and midazolam with bupivacaine intrathecally in terms of duration of analgesia and haemodynamic parameters. Materials and Methods: This...