Subhypnotic doses of propofol do not relieve pruritus induced by intrathecal morphine after cesarean section

The purpose of this study was to determine whether subhypnotic doses of propofol effectively relieve pruritus in women who received intrathecal morphine for postoperative analgesia after cesarean delivery. Twenty-nine women who developed pruritus after undergoing an elective cesarean section and receiving intrathecal morphine (0.25 mg) for postoperative analgesia were enrolled in this randomized, prospective, double-blind study. The women were randomly assigned to receive either 1 mL of propofol (n = 17) or 1 mL of placebo (n = 12) I.V. Pruritus was evaluated 5 min after treatment. In the absence of successful treatment, the women received another 1 mL of the same drug. Pruritus was again evaluated 5 min after the second dose. We found that pruritus was successfully treated twice in the propofol group and once in the placebo group (P = not significant). The antipruritic action of propofol lasted for up to 6 h in one woman and 15 min in the other. The one success in the placebo group lasted for 15 min. We conclude that the success rate of propofol in treating pruritus in women who received intrathecal morphine for postoperative analgesia after cesarean delivery is not significantly different from that of placebo.

Pruritus is a common and bothersome side effect of neuraxial opioids after cesarean section. Subhypnotic doses of I.V. propofol (10 mg) have been used to treat pruritus caused by neuraxial opioids. In this prospective, randomized, double-blind study, we found that propofol does not relieve pruritus in women who underwent cesarean section and received intrathecal morphine sulfate (0.25 mg) for postoperative pain relief.