Intrathecal morphine causes intense itching which is very bothersome. Nalbuphine antagonizes this effect when given intravenously. This trial is to find out if nalbuphine added to intrathecal morphine has an effect on morphine related pruritus while still maintaining adequate analgesia.
The study will be performed in MiniaUniversity Hospitals, after obtaining approval from the local ethics committee. All patients will have a peripheral IV cannula 18 G inserted; standard non-invasive monitors will be applied. Patients undergoing major abdominal surgery will be divided into 2 groups to receive intrathecal morphine 300 micrograms with or without nalbuphine 1mg prior to anesthesia. General anesthesia is then given to patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
70
intrathecal morphine 300 micrograms
intrathecal nalbuphine 2mg.
anesthesia&ICU department
Minya, Egypt
RECRUITINGpruritus
Pruritus score (1: no pruritus; 2: mild pruritus, treatment not requested; 3: moderate pruritus, treatment requested; 4: severe pruritus).
Time frame: 2 hours postoperatively
pruritus
Pruritus score (1: no pruritus; 2: mild pruritus, treatment not requested; 3: moderate pruritus, treatment requested; 4: severe pruritus).
Time frame: 4 hours postoperatively
pruritus
Pruritus score (1: no pruritus; 2: mild pruritus, treatment not requested; 3: moderate pruritus, treatment requested; 4: severe pruritus).
Time frame: 24 hours postoperatively
postoperative pain
assessed with a verbal numeric pain score(NRS) where 0: no pain; 10: worst imaginable pain
Time frame: 2 hours postoperative
postoperative pain
assessed with a verbal numeric pain score(NRS) where 0: no pain; 10: worst imaginable pain
Time frame: 4 hours postoperative
postoperative pain
assessed with a verbal numeric pain score(NRS) where 0: no pain; 10: worst imaginable pain
Time frame: 24 hours postoperative
postoperative nausea and vomiting
four-point rating score (1: no nausea or vomiting, 2: queasy, 3: severe nausea, 4: vomiting
Time frame: 2 hours postoperative
postoperative nausea and vomiting
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four-point rating score (1: no nausea or vomiting, 2: queasy, 3: severe nausea, 4: vomiting
Time frame: 4 hours postoperative
postoperative nausea and vomiting
four-point rating score (1: no nausea or vomiting, 2: queasy, 3: severe nausea, 4: vomiting
Time frame: 24 hours postoperative
Sedation
four-point sedation score (1: fully awake; 2: somnolent, responds to call; 3: somnolent, responds to tactile stimulation; 4: asleep, responds to painful stimulation).
Time frame: 2 hours postoperative
Sedation
four-point sedation score (1: fully awake; 2: somnolent, responds to call; 3: somnolent, responds to tactile stimulation; 4: asleep, responds to painful stimulation).
Time frame: 4 hours postoperative
Sedation
four-point sedation score (1: fully awake; 2: somnolent, responds to call; 3: somnolent, responds to tactile stimulation; 4: asleep, responds to painful stimulation).
Time frame: 24 hours postoperative