Recurrent Herpes Simplex Virus Labialis and the Use of Epidural Morphine in Obstetric Patients

Crone, L-A. L.; Conly, John; Clark, Keith M.; Crichlow, Allison C.; Wardell, Gaylord C.; Abitnew, A.; Rea, Lottie M.; Cronk, S. L.; Anderson, Catherine M.; Tan, Leonard; Albritton, William L.

doi:10.1097/00132582-198810000-00032

Cited by 3 publications

(3 citation statements)

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“…[6] Therefore, tramadol has the potential to provide effective postoperative analgesia, with no risk of respiratory depression after central neuraxial administration. However, pruritus, nausea, vomiting, urinary retention, activation of herpes labialis[7] and risk of unpredictable respiratory depression[89] have directed the clinicians to use a lower dose of tramadol that can be used intrathecally to produce effective and prolonged analgesia without such complications.…”

Section: Introductionmentioning

confidence: 99%

Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after major gynecological surgeries

Chakraborty¹,

Chakrabarti

Bhattacharya

2008

Indian J Pharmacol

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The analgesic effect of the centrally acting opioid, tramadol, is well-known. It has been shown in clinical studies that using tramadol epidurally can provide longer duration of analgesia, without the common side effects of opioids. The study was undertaken to evaluate the duration of analgesia and/or pain free period produced by intrathecal tramadol added to bupivacaine in patients undergoing major gynecological surgery in a randomized double blind placebo controlled protocol. Fifty patients ASA I & II scheduled for Wardmayo's operation and Fothergill's operation were randomly allocated to two equal groups. Group A (n=25) received 3 ml of 0.5% hyperbaric bupivacaine (15 mg) with 0.2 ml of normal saline and Group B (n=25) received 3 ml 0.5% hyperbaric bupivacaine and 0.2 ml (20 mg) tramadol by intrathecal route at L3-4 inter space. Standard monitoring of the vital parameters was done during the study period. Levels of sensory block and sedation score were recorded every two minutes for the first 20 minutes, and then every ten minutes for the rest of the surgical procedure. Assessment of pain was done using Visual Analogue Scale (VAS). The study was concluded when the VAS was more than 40 mm, postoperatively. The patient was medicated and the time was recorded. Duration of analgesia or pain free period was estimated from the time of completion of spinal injection to administration of rescue analgesic or when the VAS score was greater than 40 mm. In Group B patients, the VAS score was significantly lower, as compared to Group A patients. The duration of analgesia was 210 ± 10.12 min in Group A; whereas, in Group B, it was 380 ± 11.82 min, which was found to be significant.

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Section: Introductionmentioning

confidence: 99%

Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after major gynecological surgeries

Chakraborty¹,

Chakrabarti

Bhattacharya

2008

Indian J Pharmacol

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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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“…[17][18][19][20][21][22][23][24] These reports were followed by retrospective and prospective trials that confirmed an increased rate of oral HSV reactivation among women receiving neuraxial morphine as compared with systemic morphine for postcesarean delivery analgesia. These studies are summarized in Table 1.…”

Section: Hsv Reactivation After Neuraxial Morphine For Cesarean Delivmentioning

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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Recurrent Herpes Simplex Virus Labialis and the Use of Epidural Morphine in Obstetric Patients

Cited by 3 publications

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Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after major gynecological surgeries

Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after major gynecological surgeries

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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