How to treat opioid related pruritis?
Pruritus is one of the most common side effects of epidural or intrathecal administration of opioids, with an incidence of approximately 60% versus about 15% to 18% for epidural local anesthetic administration or systemic opioids. Many drugs have been evaluated for the prevention and treatment of opioid-induced pruritus, which can be difficult to manage and quite bothersome for some patients. Low doses of intravenous naloxone, naltrexone, nalbuphine, and droperidol appear to be efficacious for the pharmacologic control of opioid-induced pruritus. Poor opioid receptor antagonists are not ideal therapeutic agents against pruritus, because opioid analgesia is also reversed by these agents.