Increased Incidence of Itching and Herpes Simplex in Patients Given Epidural Morphine after Cesarean Section

Gieraerts, Roland; Navalgund, A.; Vaes, L.; Soetens, M.; Chang, J. S.; Jahr, Jonathan S.; McMorland, G. H.

doi:10.1097/00132582-198807000-00042

Cited by 5 publications

(9 citation statements)

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“…Given the immunosuppressive effects of opioids, it has been demonstrated that morphine reactivates latent HSV (Davies et al, 2005 ). Gieraerts et al reported high prevalence of HSV infection in patients receiving epidural morphine following cesarean section (Gieraerts et al, 1987 ). A significant association between the use of epidural morphine which is commonly used for postoperative analgesia after cesarean section and reactivation of oral herpes in the obstetric population has also been reported (Crone et al, 1990 ).…”

Section: Opioids and Viral Infectionmentioning

confidence: 99%

Opioids and Viral Infections: A Double-Edged Sword

et al. 2016

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Opioids and their receptors have received remarkable attention because they have the ability to alter immune function, which affects disease progression. In vitro and in vivo findings as well as observations in humans indicate that opioids and their receptors positively or negatively affect viral replication and virus-mediated pathology. The present study reviews recent insights in the role of opioids and their receptors in viral infections and discusses possible therapeutic opportunities. This review supports the emerging concept that opioids and their receptors have both favorable and unfavorable effects on viral disease, depending on the type of virus. Targeting of the opioid system is a potential option for developing effective therapies; however caution is required in relation to the beneficial functions of opioid systems.

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Section: Opioids and Viral Infectionmentioning

confidence: 99%

Opioids and Viral Infections: A Double-Edged Sword

et al. 2016

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“…[3][4][5]7 Although the benefits of postdelivery analgesia including better maternal comfort and mobility for improved…”

Section: Discussionmentioning

confidence: 99%

Possible Neonatal Herpes Simplex Virus (HSV) Acquired Postpartum from Maternal Oral HSV Reactivation after Neuraxial Morphine

2014

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In this report, we describe a case of a neonatal oral herpes simplex virus (HSV) infection possibly acquired from a mother who had oral HSV reactivation in association with neuraxial morphine. Neuraxial morphine is commonly administered for postpartum analgesia after cesarean delivery. While there is evidence that neuraxial morphine increases the risks of oral HSV reactivation in parturients, there has been no report of neonatal HSV infection directly acquired from a mother who had HSV recurrence from neuraxial morphine.

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“…The first prospective trial specifically addressing neuraxial morphine and HSV reactivation rates was conducted by Gieraerts et al 25 Patients receiving epidural morphine for postcesarean delivery analgesia demonstrated a higher rate of reactivation than those receiving systemic morphine. The small number of patients in the trial and low baseline prevalence of HSV infection made it difficult to assess the true risk of HSV reactivation from epidural morphine.…”

Section: Hsv Reactivation After Neuraxial Morphine For Cesarean Delivmentioning

confidence: 99%

“…The most frequently postulated, but unproven, mechanism for HSV reactivation is that irritation from facial scratching due to neuraxial opioid-induced pruritus (incidence ranging from 48% to 81%) leads to reactivation. [25][26][27] The mechanism for opioid-induced pruritus is also not fully elucidated, but seems to be mediated primarily via direct or indirect activation of central nervous system -opioid receptors, a high density of which are expressed in the trigeminal nerve. 38,39 A doseresponse study using epidural morphine (1.5-5 mg) demonstrated no dose response in severity of pruritus.…”

Section: Postulated Mechanisms For Hsv Reactivation With Neuraxial Momentioning

confidence: 99%

Neuraxial Morphine and Oral Herpes Reactivation in the Obstetric Population

Bauchat

2010

Anesthesia &Amp; Analgesia

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Neuraxial morphine administration is a common strategy for providing postcesarean delivery analgesia. Morphine delivered via this route increases the risk of herpes labialis (oral herpes) reactivation, a disease common in women of childbearing age. A primary concern is risk of transmission to the neonate from maternal reactivation. The benefits to the mother of this form of analgesia outweigh the risk of neonatal herpes acquired postpartum from maternal recurrence because serious neonatal morbidity from recurrent herpes has not been described.

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Increased Incidence of Itching and Herpes Simplex in Patients Given Epidural Morphine after Cesarean Section

Cited by 5 publications

References 0 publications

Opioids and Viral Infections: A Double-Edged Sword

Opioids and Viral Infections: A Double-Edged Sword

Possible Neonatal Herpes Simplex Virus (HSV) Acquired Postpartum from Maternal Oral HSV Reactivation after Neuraxial Morphine

Neuraxial Morphine and Oral Herpes Reactivation in the Obstetric Population

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