Pruritus, neuraxial morphine and recrudescence of oral herpes simplex and treatment: an educational review in obstetric patients

Peter Van de Putte; Jonathan S Jahr; Roland Gieraerts; Jamielynn Hanam-Jahr; Marc Van de Velde

doi:10.1136/rapm-2021-103461

Pruritus, neuraxial morphine and recrudescence of oral herpes simplex and treatment: an educational review in obstetric patients

Reg Anesth Pain Med. 2022 May 9:rapm-2021-103461. doi: 10.1136/rapm-2021-103461. Online ahead of print.

Authors

Peter Van de Putte¹, Jonathan S Jahr², Roland Gieraerts¹, Jamielynn Hanam-Jahr³, Marc Van de Velde⁴

Affiliations

¹ Anesthesiology, Imeldaziekenhuis, Bonheiden, Belgium.
² Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA j.s.jahr@ucla.edu.
³ Anesthesiology, Beverly Hills Aesthestic Dentistry, Beverly Hills, California, USA.
⁴ Anesthesiology, KU Leuven, Leuven, Belgium.

PMID: 35534019
DOI: 10.1136/rapm-2021-103461

Abstract

Neuraxial opioids are well known to cause itching, which may be challenging to treat. Neuraxial morphine has been demonstrated to cause recrudescent herpes simplex viruses (HSV-1), especially in women during labor and childbirth with neuraxial analgesia, and may be an occult etiology of refractory itching. This educational review summaries the clinical and epidemiological characteristics associated with recrudescent HSV-1 in patients treated with neuraxial opioids, especially morphine.

Keywords: Drug-Related Side Effects and Adverse Reactions; Injections, Spinal; OUTCOMES; Opioid-Related Disorders; Postoperative Complications.

Publication types

Review