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After the approval from institutional review committee and written consent received from the patient, 50 healthy parturients of ASA I and II physical status undergoing caesarean section under spinal anaesthesia were enrolled for the study.They were randomly categorized into placebo group (2 ml normal saline) and treatment group (2 ml of 4 mg ondansetron), each group containing 25 patients.Adjuvant analgesics are defined as drugs with a primary indication other than pain that have analgesic properties in some painful conditions.The group includes numerous drugs in diverse classes.Respiratory depression or decreased oxygen saturation unresponsive to oxygen therapy may be caused by the addition of opioids to the epidural solution. If there are no opioids or clonidine in the solution but sedation is present a high block or local anaesthetic toxicity must be urgently excluded.If the patient has a temperature C, or is suspected of having sepsis with potential for bacteraemia, the epidural catheter may need to be removed.Mild motor block is common following this initial period.However, because of the serious consequences of epidural abscess and epidural haematoma, all dense motor block after epidural insertion must be reported to, then thoroughly assessed by CPMS staff.

neuraxial analgesia and non sedating antihistamines-57neuraxial analgesia and non sedating antihistamines-62

Regrettably, researchers have consistently demonstrated that pain control is often inadequate for those who are dying. (2016) analyzed the 2007 National home health and hospice care survey and found only 70% of patients assessed with a valid pain scale achieved improvement or freedom from pain.The major symptoms that may need management at the end of life are pain, anxiety, nausea, vomiting, secretions and terminal restlessness. Anderson Symptom Inventory (MDASI) developed for use with cancer patients which comprise 37% of hospice patients.There are several symptom assessment tools available. This tool measures pain, fatigue, disturbed sleep, distress (emotional), shortness of breath, drowsiness, dry mouth, sadness, difficulty remembering, numbness or tingling, lack of appetite, nausea, and vomiting.Various mechanisms have been postulated for the opioid-induced pruritus, with a variety of medications with different mechanisms of actions formulated for the prevention and treatment.But, the results are inconsistent and hence the prevention and treatment of opioid-induced pruritus still remains a challenge.




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