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Canadian Journal of Anesthesia, Vol 33, 737-740, Copyright © 1986 by Canadian Anesthesiologists' Society

The Effect of Epinephrine in Local Anaesthetic on Epidural Morphine-induced Pruritus

M. J. DOUGLAS MD FRCP1, J.H. K. KIM MD FRCP1, P.L. E. ROSS MD BSC (Meds) FRCP1, and G. H. McMORLAND MB CHB FRCP1

1 Department of Anaesthesia, University of British Columbia and Grace Hospital, Vancouver, B.C.

Address correspondence to: Dr. M.J. Douglas, Department of Anaesthesia. Grace Hospital, 4490 Oak Street, Vancouver, B.C. V6H 3V5.

The severity of epidural morphine-induced pruritus was evaluated following the addition of epinephrine to the local anaesthetic solution used for Caesarean section anaesthesia. The local anaesthetic solutions used were: Group I - 0.5 per cent bupivacaine plain - 20 patients. Group II - 0.5 per cent bupivacaine with 1: 400,000 epinephrine - 25 patients. Group III - 0.5 per cent bupivacaine with 1: 200,000 epinephrine for the 3 ml "test dose" followed by 0.5 per cent bupivacaine plain for anaesthesia - 21 patients.

The severity of the pruritus, as measured by completion of a visual analogue "itch scale" and by requests for medication for pruritus, was statistically significantly greater in both groups in which epinephrine was added. This effect was not dose-related, as the "test dose" group (15 µg epinephrine) experienced the most severe itch. This latter difference was also statistically significant (p < 0.05).

Key Words: OBSTETRICAL ANAESTHESIA: epidural • ANALGESIA: epidural morphine • SYMPATHETIC NERVOUS SYSTEM, CATECHOLAMINES: epinephrine






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Copyright © 1986 by the Canadian Anesthesiologists' Society.