Effects of sub-hypnotic doses of propofol on the side effects of intrathecal morphine

• Published in: British journal of anaesthesia : BJA Vol. 73; no. 3; pp. 411 - 412
• Main Authors: TÖRN, K., TUOMINEN, M., TARKKILA, P., LINDGREN, L.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.09.1994; Oxford University Press
• Subjects: Aged; Aged, 80 and over; Anaesthetics i.v; Anaesthetics i.v., propofol; Analgesics opioid; Analgesics opioid, morphine Vomiting, nausea; Biological and medical sciences; Double-Blind Method; Drug toxicity and drugs side effects treatment; Humans; Infusions, Intravenous; Medical sciences; Middle Aged; Morphine - adverse effects; morphine Vomiting; nausea; Nausea - chemically induced; Nausea - prevention & control; Pharmacology. Drug treatments; Postoperative Complications - prevention & control; propofol; Propofol - therapeutic use; Pruritus - chemically induced; Pruritus - prevention & control; Toxicity: digestive system; Urinary Retention - chemically induced; Urinary Retention - prevention & control; Vomiting - chemically induced; Vomiting - prevention & control; Analgesics opioid, morphine Vomiting, nausea; Anaesthetics i.v., propofol; Human; Drug combination; Intravenous administration; Toxicity; Morphine; Opiates; Nausea; Narcotic analgesic; Intrathecal administration; Prevention; Chemotherapy; General anesthetic; Vomiting; Digestive diseases
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/73.3.411

We have studied the effect of propofol on the side effects associated with intrathecal morphine in 40 patients undergoing major arthroplasty. Patients received spinal anaesthesia with plain 0.5% bupivacaine 20 mg mixed with preservative-free morphine 0.3 mg. Before injection of the local anaesthetic, the patients were allocated randomly to receive either a bolus dose of propofol 10mg followed by an infusion of 30 mg/24 h or equal volumes of 10% Intralipid (control group). The number of patients without postoperative nausea and vomiting (PONV) was similar in both groups. However, the incidence of nausea and vomiting was lower in the propofol (13 and 22, respectively) than in the control (34 and 36) group (P ≤ 0.01 and P ≤ 0.05, respectively). Severe vomiting episodes were less frequent in the propofol group (1 vs 11; P ≤ 0.05). Four patients in the propofol group and 12 patients in the control group had itching (P ≤ 0.05). The incidence of urinary retention was similar in both groups. There was no additional sedation attributable to propofol. In conclusion, sub-hypnotic doses of propofol protected significantly against itching and had a modest effect on PONV after intrathecal morphine.