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RecruitingNCT07054775Updated Jul 8, 2025

Comparison of Pruritus Incidence After Intrathecal Morphine 0.1 vs 0.2 mg in Cesarean Section

A Phase 4 interventional study of Morphine Sulfate in Pruritus Caused by Drug, sponsored by Khon Kaen University. Recruiting at 2 sites in Thailand. Open to female participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-07-08.

Sponsored by Khon Kaen University · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
69
Allocation
Randomized
Ages
18 Years to 45 Years
Sex
Female
01

Study summary

This study compares the incidence of pruritus (itching) requiring treatment between two doses of intrathecal morphine (0.1 mg vs 0.2 mg) when used for spinal anesthesia during cesarean section. The study aims to determine if the lower dose (0.1 mg) can reduce pruritus incidence while maintaining adequate pain relief.

Read the detailed description

Spinal anesthesia is a standard technique for cesarean section. Intrathecal morphine (ITM) provides prolonged and effective analgesia but may cause adverse events including pruritus, nausea, vomiting, and respiratory depression. Current practice at Srinagarind Hospital uses ITM 0.2 mg for spinal anesthesia in cesarean section. This study investigates whether reducing the ITM dose to 0.1 mg can decrease pruritus incidence while preserving analgesic effectiveness.

02

Conditions studied

  • Pruritus Caused by Drug
03

Who can participate

Ages eligible
18 Years to 45 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria: • Pregnant women aged 18-45 years

  • Full-term pregnancy
  • Scheduled for non-emergency cesarean section
  • ASA physical status I-III
  • Non-complicated pregnancy

Exclusion Criteria:

  • Contraindication to spinal anesthesia or study drugs
  • Refusal to participate in the study
  • BMI ≥ 40 kg/m²
  • History of systemic skin disease or current itchy skin condition
  • Use of antihistamines or anti-pruritic medications within 3 days prior to surgery
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Outcomes assessor)
Enrollment
69 participants (estimated)

Study arms

  • Active comparator
    ITM 0.1 mg

    Participants receive spinal anesthesia with 0.5% hyperbaric bupivacaine plus morphine 0.1 mg intrathecally

    Drug: Morphine Sulfate

  • Active comparator
    ITM 0.2 mg

    Participants receive spinal anesthesia with 0.5% hyperbaric bupivacaine plus morphine 0.2 mg intrathecally

    Drug: Morphine Sulfate

Interventions

  • DrugMorphine Sulfate

    intrathecal administered morphine

05

What researchers measure

Primary outcomes

  1. Incidence of pruritus requiring treatment [Time Frame: 24 hours post-operatively]

    * Percentage of participants requiring treatment for pruritus within 24 hours after spinal anesthesia * Measured using numerical rating scale (0-10), with treatment indicated for score ≥4 * Percentage of participants requiring treatment for pruritus within 24 hours after spinal anesthesia * Measured using numerical rating scale (0-10), with treatment indicated for score ≥4 * Percentage of participants requiring treatment for pruritus within 24 hours after spinal anesthesia * Measured using numerical rating scale (0-10), with treatment indicated for score ≥4

    Time frame: 24 hours

06

Study locations

2 of 2 sites recruiting
  • Faculty of Medicine, Khon Kaen University
    Khon Kaen, 40002, Thailand
    • Thepakorn Sathitkarnmanee, MD · Contact · thepakorns@gmail.com · +66819547622
    • Sirirat Tribuddharat, MD, PhD · Principal investigator
    Recruiting
  • Thepakorn Sathitkarnmanee
    Khon Kaen, 40002, Thailand
    • Thepakorn Sathitkarnmanee, MD · Contact · thepakorns@gmail.com · 66-81-9547622
    • Thepakorn Sathitkarnmanee, MD · Principal investigator
    Recruiting
07

References and documents

Publications

  • Kumar K, Singh SI. Neuraxial opioid-induced pruritus: An update. J Anaesthesiol Clin Pharmacol. 2013 Jul;29(3):303-7. doi: 10.4103/0970-9185.117045. PubMed 24106351 ↗
  • Waxler B, Dadabhoy ZP, Stojiljkovic L, Rabito SF. Primer of postoperative pruritus for anesthesiologists. Anesthesiology. 2005 Jul;103(1):168-78. doi: 10.1097/00000542-200507000-00025. PubMed 15983470 ↗
  • Sultan P, Halpern SH, Pushpanathan E, Patel S, Carvalho B. The Effect of Intrathecal Morphine Dose on Outcomes After Elective Cesarean Delivery: A Meta-Analysis. Anesth Analg. 2016 Jul;123(1):154-64. doi: 10.1213/ANE.0000000000001255. PubMed 27089000 ↗
  • Gehling M, Tryba M. Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis. Anaesthesia. 2009 Jun;64(6):643-51. doi: 10.1111/j.1365-2044.2008.05817.x. PubMed 19462494 ↗
  • Palmer CM, Emerson S, Volgoropolous D, Alves D. Dose-response relationship of intrathecal morphine for postcesarean analgesia. Anesthesiology. 1999 Feb;90(2):437-44. doi: 10.1097/00000542-199902000-00018. PubMed 9952150 ↗
  • Wang W, Zhou L, Sun L. Ondansetron for neuraxial morphine-induced pruritus: A meta-analysis of randomized controlled trials. J Clin Pharm Ther. 2017 Aug;42(4):383-393. doi: 10.1111/jcpt.12539. Epub 2017 May 2. PubMed 28464238 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT07054775
Lead sponsor
Khon Kaen University
Responsible party
Thepakorn Sathitkarnmanee (Associate professor, Khon Kaen University) — Principal investigator
First posted
Jul 8, 2025
Start date
Jun 1, 2025
Primary completion
Oct 31, 2025 (estimated)
Completion
Nov 30, 2025 (estimated)
Last update
Jul 8, 2025

Study contacts

Thepakorn Sathitkarnbmanee
Contact
thepakorns@gmail.com
66-81-9547622
Sirirat Tribuddharat
Contact
sirirat.tribuddharat@gmail.com
66-81-6205920
Thepakorn Sathitkarnmanee
study chair · Khon Kaen University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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