Treatment of Epidural-Morphine-Induced Pruritus: Propofol Versus Naloxone

경막외 Morphie 투여시 생기는 소양증에 대한 Propofol과 Naloxone의 효과 비교

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 reported 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 ${\mu}g/kg$ 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 postoperative 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.