The effect of intravenous propofol or pentazocine in preventing pruritus due to intrathecal fentanyl in lower limb surgery compared with control group

Abstract

Background: Using intrathecal opioid in surgery operation causes a desirable analgesic. But one of its side effects is pruritus and then, patients’ dissatisfaction. Therefore, the present study investigated the effect of intravenous propofol or pentazocine in preventing pruritus resulted from prescribed fentanyl. Methods: This was a controlled randomized double-blinded clinical trial study carried out on 150, 18-65-year-old adults, candidate for lower limb surgery under spinal analgesia, who were selected using simple random sampling method. The first 50 patients received 20 milligrams of intravenous propofol, the second 50 patients received 15 milligrams of intravenous pentazocine, and the third 50 patients received placebo, 10 minutes after analgesia. The side effects resulted from drug injection were recorded if any occurred. All the patients were under spinal anesthesia by 3 milliliters of 0.5 Marcaine, and 25 microgram fentanyl. The hemodynamic situation of patients was recorded at regular intervals before, during, and after surgery. Findings: Meaningful modifications in heart rate (HR) and mean arterial pressure (MAP) were reported in all three groups (P < 0.05), but the modifications in oxygen saturation (SaO2) were meaningless (P > 0.05). Pruritus in patients receiving propofol was relatively constant, but in control and pentazocine group, meaningful increase in pruritus was reported (P < 0.05). Conclusion: Propofol beside fentanyl in comparison to pentazocine or placebo plays more significant role in decreasing pruritus; however, pentazocine can be effective too with intrathecal opioid. © 2018, Isfahan University of Medical Sciences(IUMS). All rights reserved.