Korean J Pain.  2006 Jun;19(1):91-95. 10.3344/kjp.2006.19.1.91.

Effects of Epidural Naloxone on Pruritus Induced by Hydromorphone Epidural Patient-Controlled Analgesia

• Bang SR
• Kim HS
• Kim JH
• Sim WS
• Gwak MS
• Yang MK
• Kim CS
• Hahm TS
• Cho HS
• Choi DH
• Kim TH

• KMID: 2278023
• DOI: http://doi.org/10.3344/kjp.2006.19.1.91

Abstract

BACKGROUND: Opioid delivered by epidural patient-controlled analgesia (PCA) is effective in relieving pain after surgery, but it is associated with side effects, such as nausea, vomiting, pruritus, respiratory depression, and urinary retention. The purpose of this study was to compare hydromorphone related side effects and the quality of analgesia when naloxone was added to epidural PCA regimen.
METHODS
Fifty-two thoracotomy patients with PCA were allocated blindly into two groups. Patients in group H (n = 26) received continuous epidural hydromorphone (16microgram/ml) in 0.1% bupivacaine; patients in group N (n = 26) received an epidural infusion containing naloxone (2 microgram/ml) and hydromorphone (16microgram/ml) in 0.1% bupivacaine. The basal rate of PCA was 4 ml/hr and the demand dose was 1.5 ml with a lockout time of 15 min. Pain intensity, sedation, pruritus, nausea and vomiting, respiratory depression were checked at 6, 12, 24 hours postoperatively.
RESULTS
The Visual Analog Scale (VAS) scores were significantly lower in group H than in group N. There were no significant differences in the overall incidence of pruritus, nausea and sedation between the two groups.
CONCLUSIONS
Continuous epidural infusion of naloxone combined with hydromorpho-ne is not effective in reducing the incidence and severity of pruritus induced by epidural hydromorphone.

Keyword

bupivacaine; epidural; hydromorphone; naloxone; PCA

MeSH Terms

Analgesia
Analgesia, Patient-Controlled*
Bupivacaine
Humans
Hydromorphone*
Incidence
Naloxone*
Nausea
Passive Cutaneous Anaphylaxis
Pruritus*
Respiratory Insufficiency
Thoracotomy
Urinary Retention
Visual Analog Scale
Vomiting
Bupivacaine
Hydromorphone
Naloxone