Issn Print: 0265-0215

Publication Date: 2005/05/01


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Gender differences in the development of pruritus after intrathecal sufentanil: A-364

J. M. Pego; P. Fragoso; C. Antunes; R. Domingos; C. Ferreira; M. R. Crisostomo; M. Oliveira

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Background and Goal of Study: Intra-thecal sufentanil has gained increased popularity for the last years as it allows the reduction of the doses of local anaesthetics and latency time necessary to achieve subarachnoid block (SAB). Furthermore it provides additional analgesia long past the reversal of block. Like other opioids intra-thecal sufentanil has secondary effects like nausea, vomiting, respiratory depression and pruritus. The incidence of pruritus is dependent on the dose (1) and individual susceptibility. Although the precise mechanism of opioid-associated pruritus is not known, it has been associated (2) with opioid receptors that are influenced by sexual steroids. We hypothesize that gender is a factor of susceptibility to the development of pruritus after SAB with sufentanil.
Materials and Methods: This is a prospective cohort study (n = 130). Patients 18 or older, ASA I or II were randomly selected for the study. Patients were submitted to SAB using 0,04-0,06 mg bupivacaine/cm of height and 2,5 microgram Sufentanil. We evaluated and recorded the development of pruritus every 20 min after the block until 120 min, as well as nausea, vomiting, deep sedation and hypoxia. Pruritus was classified into 4 categories: none, light, moderate, severe. Data was analysed using ANOVA.
Results and Discussions: Women have an increased susceptibility to the development of pruritus, which appeared earlier and more frequently than in men. Pregnant and pre-menopausal women have increased susceptibility although it did not reach statistical significance.
Conclusion(s): Our data shows that women are more prone to the development of pruritus after SAB with sufentanil. We propose that the mechanism underpinning this fact might be the hormonal milieu of sexual steroids in particular progesterone.
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