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Pruritus, neuraxial morphine and recrudescence of oral herpes simplex and treatment: an educational review in obstetric patients
  1. Peter Van de Putte1,
  2. Jonathan S Jahr2,
  3. Roland Gieraerts1,
  4. Jamielynn Hanam-Jahr3 and
  5. Marc Van de Velde4
  1. 1Anesthesiology, Imeldaziekenhuis, Bonheiden, Belgium
  2. 2Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
  3. 3Anesthesiology, Beverly Hills Aesthestic Dentistry, Beverly Hills, California, USA
  4. 4Anesthesiology, KU Leuven, Leuven, Belgium
  1. Correspondence to Dr Jonathan S Jahr, Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA; j.s.jahr{at}


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

  • Drug-Related Side Effects and Adverse Reactions
  • Injections, Spinal
  • Postoperative Complications
  • Opioid-Related Disorders

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  • Contributors All authors assisted with idea, writing, and review of Educational Review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.