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Herpes & Epidurals From: BUCKY_C@TSJC.Colorado.EDU Wed Apr 3 20:44:27 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Gary Kleinman: "Re: RhoGam Shortage?" Previous message: D. G. Huffman: "RhoGam Shortage?" > Subj: Primary Herpes and Epidurals >Does anyone have comment to make about epidural or spinal anesthesia for a >woman who has had primary herpes during the second trimester? Some >anesthesia folks have stated that a general anesthesia is necessary because >of the potential for the spread of HSV. I can't cite the literature references immediately, but the relationship between reactivation of the HSV and epidurals has only borne significance with respect to the use of epidural morphine. The reason, if it really happens, is quite unknown. I've done plenty of epidurals for OB patients with herpetic histories for both labor and C-section, using lidocaine and/or bupivacaine plus fentanyl without ever being told that a herpes outbreak resulted directly. Stay away from morphine and all should be okay. (the reference that rings closest seems to be from the Canadian Anesthetists Society Journal, but my periph brain is at work). Bucky Next message: Gary Kleinman: "Re: RhoGam Shortage?" Previous message: D. G. Huffman: "RhoGam Shortage?"

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