Investigating the incidence and severity of pruritus in intrathecal fentanyl injection in opium-addicted patients in lower limb orthopedic surgeries: a double-blind randomized clinical trial study

Mousavi , Seyedeh Roya; Ebrahimzadeh, Parvaneh; Yazdanpanah , Sepideh; Mousavi, Nasim Alsadat; Deylami , Mansour

Volume 82, Issue 4 (July 2024) Tehran Univ Med J 2024, 82(4): 290-298 | Back to browse issues page

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Mousavi S R, Ebrahimzadeh P, Yazdanpanah S, Mousavi N A, Deylami M. Investigating the incidence and severity of pruritus in intrathecal fentanyl injection in opium-addicted patients in lower limb orthopedic surgeries: a double-blind randomized clinical trial study. Tehran Univ Med J 2024; 82 (4) :290-298
URL: http://tumj.tums.ac.ir/article-1-13124-en.html

Investigating the incidence and severity of pruritus in intrathecal fentanyl injection in opium-addicted patients in lower limb orthopedic surgeries: a double-blind randomized clinical trial study

Seyedeh Roya Mousavi¹

, Parvaneh Ebrahimzadeh¹

, Sepideh Yazdanpanah¹

, Nasim Alsadat Mousavi²

, Mansour Deylami ^*

1- Department of Anesthesiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
2- Student Research Commiittee, Golestan University of Medical Sciences, Gorgan, Iran.
3- Department of Anesthesiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. , mansour.deylami@gmail.com

Abstract: (35 Views)

Background: Today, addiction is a major problem in modern society, which affects the management of patients during anesthesia. In patients with long-term use of opioids, higher doses of opioids are needed to create analgesia and control pain during and after surgery. Also, addicted patients have more resistance to local anesthetic drugs when they are used to perform peripheral and central nerve blocks. Therefore, many drugs are added to local anesthetics to enhance their analgesic properties, one of the most common of which is narcotic compounds. Itching caused by opium may be generalized and often occurs shortly after injection. Therefore, this study aims to investigate the amount of itching caused by intrathecal injection of fentanyl in opium addicts who undergo elective orthopedic surgeries of the lower limbs with spinal anesthesia. have been taken, designed and established.
Methods: This study was a double-blind clinical trial conducted on 68 patients who were candidates for elective lower limb orthopedic surgeries under spinal anesthesia and referred to 5 Azar Hospital in Gorgan in 2023. Patients were divided into two groups using random numbers table, Intervention (a group of addicted patients who received intrathecal marcaine together with fentanyl for spinal anesthesia) and control (a group of addicted patients who received only intrathecal marcaine for spinal anesthesia). Pruritus, nausea and vomiting were measured in both groups. Data analysis was done using descriptive statistics and inferential statistical tests.

Results: In terms of age, gender, and BMI, there was no statistically significant difference between the intervention and control groups. There was no statistically significant difference in the incidence of nausea and vomiting between the two groups. The incidence of itching was zero in the bupivacaine group and 17.6% in the fentanyl and bupivacaine group, of which 3% required anti-itch medication for treatment.
Conclusion: The results of this study showed that due to the low incidence of pruritus in the group using fentanyl along with bupivacaine, its use is beneficial in people with drug addiction.

Keywords: addiction, fentanyl, intrathecal, orthopedics, pruritus.

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Type of Study: Original Article |