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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.42

Abstract

Background and Objectives: Morphine has been used spinally for postoperative pain management for long time. However post-operative nausea, vomiting and pruritus are some of the common adverse effects of it.The incidence of pruritus being 20-100%, the prevention of pruritus remains a major challenge. This study was conducted tocompare the efficacy of chlorpheniramine maleate versus cetirizine in prevention of post-operative pruritus in patients receiving intrathecal morphine for lower segment caesarean section. Methods: 60 parturients undergoing caesarean delivery were randomly allocated in 2 groups. All patients received intrathecal bupivacaine with 100mcg morphine. One group of patients received Inj chlorpheniramine maleate 45.5mg IV and in other group oral tablet cetirizine 10mg was used as antipruritic prophylaxis. Results: Inspite of antipruritic prophylaxis the overall incidence of pruritus was high in both the groups, but it was statistically higher in cetirizine group of patients (90%) when compared to CPM group (46.7%) p value =0.001.The number of patients requiring treatment were more in cetirizine group(66.7%) when compared to CPM group(57.1%), in whom pruritus was treated with Inj.Dexamethasone 8mg IV. Conclusion: Inj chlorpheniramine maleate is better when compared to oral tablet cetirizine but neither Inj. chlorpheniramine maleate nor tab cetirizine are useful in prophylaxis of intrathecal morphine induced pruritus in patients undergoing lower segment caesarean section.

Keywords : Intrathecal morphine; Inj chlorpheniraminemaleate; Cetirizine; Pruritus; Antihistamines.

Corresponding Author : Rajesh Munigial, Post Gradaute, Department of Anesthesia, Critical Care and Pain Management, Shamanur Shivashankarappa Institute of Medical Science and Research Center, Davangere, Karnataka 577005, India. Email: rajesh.munigial@gmail.com