Buprenorphine for Pruritis RX Due to Intrathecal Narcotics

 Near Mt. Shishapangma - photo by JoAnn Sturman

 

Scott Sturman, M.D.


Post operative pruritis can be unpleasant for patients receiving intrathecal narcotics.  This side effect is a common problem, and it is difficult to predict which patients will be at risk.  Since Nubain is no longer available, the treatment choices are inadequate.

Buprenorphine, an agonist-antagonist opioid, can be used effectively to treat patients with intractable pruritis.  One must use care with patients using chronic high dose narcotics, but most patients can be successfully treated with 0.15mg IV every six hours.

Although IV buprenorphine is effective in the treatment of severe pruritis in the recovery room or on the hospital floor, it would be interesting to determine the benefit of prophylactic IM buprenorphine given at the conclusion of surgery.  The pharmacodynamics of intramuscular administration early in the surgical course lends itself to preventing this nagging problem. 

Electrical Wiring Kathmandu - photo by JoAnn Sturman