Naloxone can be used to treat pruritus associated with neuraxial opioids.

Naloxone can be used to treat pruritus associated with neuraxial opioids.

• A. It treats pruritus associated with neuraxial opioids
• B. It has no effect on pruritus
• C. It worsens pruritus
• D. It is contraindicated with pruritus

Answer: (A)

Pruritus from neuraxial opioids is driven by mu-opioid receptor activation in central itch pathways. Naloxone, a mu-opioid receptor antagonist, can block those receptors enough to relieve the itch. Using a low dose reduces the pruritus without fully reversing analgesia, because only a small amount of receptor blockade is needed to calm the itch signaling while analgesia often persists with partial receptor engagement. This makes low-dose naloxone an effective strategy for neuraxial opioid–induced itching, whereas higher doses would risk losing pain relief. Histamine release is not the main driver of this itch, so antihistamines are less reliable in this context.

Pruritus from neuraxial opioids is driven by mu-opioid receptor activation in central itch pathways. Naloxone, a mu-opioid receptor antagonist, can block those receptors enough to relieve the itch. Using a low dose reduces the pruritus without fully reversing analgesia, because only a small amount of receptor blockade is needed to calm the itch signaling while analgesia often persists with partial receptor engagement. This makes low-dose naloxone an effective strategy for neuraxial opioid–induced itching, whereas higher doses would risk losing pain relief. Histamine release is not the main driver of this itch, so antihistamines are less reliable in this context.