Evidence map›Paper›PMID 37455197›Full record

SynthesisBritish journal of anaesthesia2023

Pharmacological agents for prevention of pruritus in women undergoing Caesarean delivery with neuraxial morphine: a systematic review and Bayesian network meta-analysis.

Preet M Singh, Pervez Sultan, James O'Carroll, Lindsay Blake, Brendan Carvalho, Narinder P Singh, David T Monks

2 registry-linked trialsOpen access · bronzeAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04805073 phase4completednot on this map

Assessing Efficacy of Intramuscular Promethazine for the Treatment of Intrathecal Morphine Induced Pruritus

TypeinterventionalSponsorUniversity of FloridaRan2021 to 2024Enrolled72ConditionsPruritus, Pregnancy RelatedArmsPromethazine, Placebo
NCT06715657 phase4not yet recruitingnot on this mapstarted 2024, after this paper: background citation

Effect of Propofol Administration Time on the Incidence and Severity of Intrathecal Morphine-induced Pruritus in Parturient Undergoing Elective Cesarean Delivaries: A Prospective, Randomized, Comparative Controlled Study

TypeinterventionalSponsorAssiut UniversityRan2024 to 2027Enrolled204ConditionsCesarean SectionArmsMorphine intrathecal, propofol
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. The intrathecal morphine analgesia for full endoscopic lumbar discectomy: a prospective dose-finding study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Preet M SinghWashington University in Saint Louis, Anesthesiology, Barnes Jewish Hospital, Saint Louis, MO, USA. Electronic address: singh.p@wustl.edu.
Pervez SultanDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA.
James O'CarrollDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA.
Lindsay BlakeUniversity of Arkansas for Medical Sciences, Little Rock, AR, USA.
Brendan CarvalhoDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, USA.
Narinder P SinghDepartment of Anesthesia, Mount Sinai Hospital, Toronto, ON, Canada.
David T MonksWashington University in Saint Louis, Anesthesiology, Barnes Jewish Hospital, Saint Louis, MO, USA.
Stanford Medicine · USBarnes-Jewish Hospital · USMount Sinai Hospital · CAUniversity of Arkansas for Medical Sciences · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuraxial opioids provide effective analgesia for Caesarean delivery, however, pruritus can be a troubling side-effect. Effective agents to prevent pruritus are needed. Our objective was to perform an updated systematic review and network meta-analysis to provide clinicians with a comparison of relative efficacy of available interventions to reduce the incidence of pruritus, induced by either intrathecal or epidural single-shot morphine, in women undergoing Caesarean delivery.

methodsDatabases systematically searched (up to January 2022) included PubMed MEDLINE, Web of Science, EBSCO CINAHL, Embase, LILACS, and two Cochrane databases. We included randomised, controlled trials involving adult female patients undergoing Caesarean delivery. We pooled trials comparing interventions used for preventing pruritus after Caesarean delivery and performed a Bayesian model network meta-analysis.

resultsThe final primary network included data from comparisons of 14 distinct interventions (including placebo) used to reduce the incidence of pruritus in 6185 participants. We judged five interventions to be 'definitely superior' to placebo: propofol, opioid agonist-antagonists (neuraxial), opioid antagonists, opioid agonist-antagonists (systemic), and serotonin antagonists. For the network evaluating the incidence of severe pruritus (warranting additional therapeutic treatment of pruritus), data were available for 14 interventions (including placebo) in 4489 patients. For this outcome, we judged three interventions to be 'definitely superior' to placebo: dopamine antagonists (neuraxial) and systemic and neuraxial opioid agonist-antagonists.

conclusionOur analysis found several interventions to be effective in reducing the incidence of pruritus. Although sub-hypnotic doses of propofol appear to have an antipruritic effect, replication of this finding and further investigation of optimal dosing are warranted. SYSTEMATIC REVIEW PROTOCOL: PROSPERO (CRD42022367058).

Indexed as

MorphinePropofolAdultAnalgesics, OpioidBayes TheoremCesarean SectionFemaleHumansPregnancyPruritusAnalgesics, OpioidMorphinePropofolCaesarean deliveryneuraxialopioidspregnancypruritus

Identifiers

PMID37455197
PMCPMC10515090
OpenAlexW4384344270

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.