itching after cesarean section

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Hi everyone,

I have a question about I had yesterday. She had a c-section and she was complaining of pruritus all over the body. She had an epidural block for the gurgery and morphine for analgesia. I am wondering why is that? Is tis because she was on morphine?:uhoh3:

thanx

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Specializes in NICU, Infection Control.

In a way. It's likely from the Duramorph used in the epidural. This a very common side effect. There may be an order for Benadryl.

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Specializes in OB.

morphine makes me wanna scrape all my skin off with a steak knife!!!

very itchy!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Benedryl or Nubain both work where I am. But I use Benedryl first---Durmorph is infamous for terrible itching later on.

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Specializes in Community, OB, Nursery.
Durmorph is infamous for terrible itching later on.

I have found this too. Ditto on the Benadryl & Nubain. I like to use Benadryl if they're itching but pain is well-controlled by Duramorph. If they're itching but still hurting (or nauseous) I go with Nubain.

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Specializes in L&D,- Mother/Baby.

We also have an order for Allegra 120 mg po for the itching. I like using the Nubain best.

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25 of demerol does it too

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Specializes in Community, OB, Nursery.

I don't think we use Demerol AT ALL where I am. I remember when I worked med-surg (different hospital) we gave Dem/Phen like it was water. I haven't done that at all where I am now.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We dont' use demerol on the unit at all.

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Specializes in OB, lactation.

We don't use demerol at all, either.

I think the order of use for duramorph-related itching on our neuraxial orders go:

nubain, benedryl, narcan

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We use Benadryl.

I never ever heard of Nubain until I came on allnurses.

We use Demerol occasionally but not for itching.

steph

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Nubain is GREAT for duramorph itching. we add about 15-20mg to a liter bag and let it run for the duration of that bag. It works great. But we also have (obviously) to look for some reversal of the beneficial effects on the duramorph's pain control. That is why I use Benedryl first. But Nubain is in the MDA orders, if Benedryl is not helpful. Can't say we ever used Demerol for itching, but we have in the past, used it for post partum shaking that is persistent and troublesome. Only needed bout 12.5 mg to do the trick. We just don't use it anymore on our unit.

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