{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:34:56Z","timestamp":1759336496938,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Study Objective<\/jats:title><jats:p>This study's purpose was to determine if ondansetron can prevent pruritus after administration of intrathecal morphine in children, as has been demonstrated in adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A double\u2010blinded, randomized placebo\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Operating room and first 24\u2009h postoperative inpatient stay at an academic children's hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Forty\u2010six children aged 3\u201317\u2009years, who received 4\u20135\u2009mcg\/kg intrathecal morphine for urological or orthopedic procedures were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Children were randomized to receive intravenous ondansetron (treatment) or saline placebo (placebo), prior to intrathecal morphine administration, and q6H for 24\u2009h thereafter. Intraoperative anti\u2010emetics and postoperative rescue treatments for pruritus and nausea were standardized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Patients were interviewed q6H for scored pruritus, nausea, and pain, using standardized scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Results<\/jats:title><jats:p>The trial was terminated for futility after interim analysis. Forty\u2010six children were recruited and 45 completed data collection. No significant difference was found between both groups for incidence of pruritus (requiring treatment) [relative risk (RR) 0.9, 95% CI: 0.7, 1.2], during the first postoperative 24\u2009h. Notably, the incidence of pruritus was 84% overall, much higher than rates in previously published studies. Intravenous ondansetron significantly reduced the incidence of nausea, compared with the placebo group [RR 0.5, 95% CI: 0.3, 0.9].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found no evidence for intravenous ondansetron as an effective preventative for pruritus following intrathecal morphine in children. However, this RCT did find that the rate of pruritus following intrathecal morphine administration may be significantly higher than previously thought. Nausea and vomiting (a secondary outcome) were reduced significantly in the treatment group. The negative findings of this study reinforce the potential dangers of extrapolating the drug effects seen in adults onto pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14517","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T09:34:28Z","timestamp":1656754468000},"page":"1151-1158","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intravenous ondansetron reduced nausea but not pruritus following intrathecal morphine in children: Interim results of a randomized, double\u2010blinded, placebo\u2010control trial"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-1647","authenticated-orcid":false,"given":"Elizabeth M.","family":"Putnam","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University of Michigan Health System  Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6608-1913","authenticated-orcid":false,"given":"Rebecca A.","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Michigan Health System  Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Urology University of Michigan Health System  Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"Depatment of Orthopaedic Surgery University of Michigan Health System  Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleda","family":"Leis","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Michigan Health System  Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shobha","family":"Malviya","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Michigan Health System  Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12420"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12781"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000252418.05394.28"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(02)00501-9"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-15-18"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2014.04.007"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000066310.49139.2A"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-44605-8_17"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen202"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000181338.35454.6A"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/83.5.822"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199902000-00017"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-004-1471-7"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2016.09.004"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199309000-00019"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0265-0215.2000.00826.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200003000-00023"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21625"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.167839"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e318297e384"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/71.5.681"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/73.3.411"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000148618.17736.3C"},{"key":"e_1_2_11_25_1","first-page":"9","article-title":"Pain in children: comparison of assessment scales","volume":"14","author":"Wong DL","year":"1988","journal-title":"Pediatr Nurs"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-4060"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.169"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.01.027"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13037"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14517","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pan.14517","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.14517","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T07:47:17Z","timestamp":1692604037000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.14517"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,12]]},"references-count":28,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10]]}},"alternative-id":["10.1111\/pan.14517"],"URL":"https:\/\/doi.org\/10.1111\/pan.14517","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"type":"print","value":"1155-5645"},{"type":"electronic","value":"1460-9592"}],"subject":[],"published":{"date-parts":[[2022,7,12]]},"assertion":[{"value":"2021-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}