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The Effect of Ondansetron on Acute Opioid Tolerance in Patients Receiving Intrathecal Opioids Before Cesarean Delivery

Greer, K.C.; Terkawi, A.S.; Tsang, S.; Singla, P.; Durieux, M.E.; Tiouririne, M.

Obstetric Anesthesia Digest: June 2018 - Volume 38 - Issue 2 - p 108
doi: 10.1097/01.aoa.0000532307.96310.e9
Anesthesia Analgesia: Postoperative Analgesia

(Reg Anesth Pain Med. 2017;42(5):669–673)

Acute opioid tolerance (AOT) and opioid-induced hyperalgesia have recently been raised as concerns associated with the use of opioids as an adjunct to local anesthetics in subarachnoid block for cesarean delivery. Ondansetron has been shown in animal studies to significantly prevent and reverse AOT and opioid-induced hyperalgesia. Such effects have not yet been examined in humans, so this study aimed to investigate whether intravenous (IV) ondansetron would attenuate opioid-induced AOT. The study hypothesized that patients receiving IV ondansetron prior to cesarean delivery would require fewer opioids and have better postoperative pain scores compared with those who did not receive IV ondansetron.

Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA

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