itching after cesarean section

[mani3433]

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?

thanx

[NPinWCH]

I argue almost daily with my fellow nurses who complain about their patients complaining about the itching. They are quite fond of saying, "Oh come on...she's got to understand it's better to itch than to hurt." I've had 2 c/s one with duramorph and one with a PCA postop. Let me express to all of you that the itching isn't run of the mill, "Oh I have an itch." It is EXTREME and nothing makes it better. I hurt a little more with my PCA, but I was itch free and much happier.

Benadryl made me so groggy that I was even more miserable, itchy and sleepy are not a good combo. I litterally dug my face raw. It feels like you are constantly walking thru cobwebs or your hair keeps tickling your face. At the time we didn't offer anything else for the itching, so I had to put up with it, and Duramorph itching can last up to 10 hours post dose.

We now use Nubain almost exclusively, we've been giving it slow IVP, but I think I'm going to bring up that infusion method as it won't knock mom out so much. We also have orders for Benadryl 50mg IVP q6 h and Narcan 0.01mg IVP q5 min until itching resolved then mix 0.1mg in 100ml NS and hang at 15ml/hr. The Narcan works, BUT as it's an antagonist they end up in more pain.

I always ask my moms to rate the itching on a scale from 1-10 just like pain...that way it's easier for them to see if they got any improvement from the intervention (though I can usually tell based on the fact that they aren't ripping their skin off!)

[babyktchr, BSN, RN]

We use benadryl for that pesky itching, but our lactation guru says to be careful using it with breastfeeding moms. She only suggests one or two doses, because long term use can effect milk production.