Effects of Epidural Naloxone on Pruritus Induced by Hydromorphone Epidural Patient-Controlled Analgesia.
- Author:
Si Ra BANG
1
;
Hee Suk KIM
;
Ji Hyeok KIM
;
Woo Seok SIM
;
Mi Sook GWAK
;
Mi Kyung YANG
;
Chung Su KIM
;
Tae Soo HAHM
;
Hyun Sung CHO
;
Duck Hwan CHOI
;
Tae Hyeong KIM
Author Information
- Publication Type:Original Article
- Keywords: bupivacaine; epidural; hydromorphone; naloxone; PCA
- MeSH: Analgesia; Analgesia, Patient-Controlled*; Bupivacaine; Humans; Hydromorphone*; Incidence; Naloxone*; Nausea; Passive Cutaneous Anaphylaxis; Pruritus*; Respiratory Insufficiency; Thoracotomy; Urinary Retention; Visual Analog Scale; Vomiting
- From:The Korean Journal of Pain 2006;19(1):91-95
- CountryRepublic of Korea
- Language:Korean
- 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.
