PROPHYLACTIC RECTAL DICLOFENAC AND INTRAVENOUS TENOXICAM ADMINISTRATION REDUCE THE INCIDENCE OF INTRATHECAL MORPHINE INDUCED PRURITUS IN PATIENTS UNDERGOING ABDOMINAL SURGERY
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In this study, pruritus and pain were evaluated in patients undergoing abdominal surgery in which combined general anaesthesia and irttrathe- cal morphine was administered for intraoperative and postoperative pain control. Sixty patients aged 20-60yr, weighing 50-8Q Kg of physical status 1 or 11 scheduled for elective abdominal surgery were studied. Patients received intarthecal morphine 0.5 mg prior to induction, followed by a standard general anaesthetic technique. The patients were randomlly divided into 3 groups of 20 patients. Group A. received 2nd saline I.V. as placebo, group B, received 100mg rectal diclofenac and group C, received 20 mg 1.V. tenoxicam. All drugs were given immediately postinduction and before surgery. It was observed that the incidence of pruritus was highly significantly (P<0.001) decreased in patients receiving diclofenac and tenoxicam (20%and 15% respectively) as compared to placebo group (75%) and also patients receiving diclofenac and tenoxicam had significantly lower pruritus scores at 1/2. 2, 4. 8 and 24 hr postoperatively as well as significantly reduced pain scores at each time interval (P<0.001) as compared with placebo. The distribution of pruritus was mainly facial in all studied groups. Morphine consumption in the first 24 hr was also significantly (PC 0.001) lower in both groups ( B and C) as compared to placebo group ( A).