Pruritus distribution in neuraxial opioid use is typically localized to which areas?

Pruritus distribution in neuraxial opioid use is typically localized to which areas?

• A. Face, neck, and upper chest.
• B. Lower legs.
• C. Palms.
• D. Back.

Answer: (A)

Neuraxial opioid–induced itch is a central phenomenon that most often shows up in the cephalad region of the body. The classic pattern is itching of the face, neck, and upper chest after intrathecal or epidural morphine, rather than in distal limbs or the back. This cephalad distribution reflects central mu-opioid–driven itch pathways rather than a skin-histamine reaction, so areas like the lower legs, palms, or back are not typical sites.

Neuraxial opioid–induced itch is a central phenomenon that most often shows up in the cephalad region of the body. The classic pattern is itching of the face, neck, and upper chest after intrathecal or epidural morphine, rather than in distal limbs or the back. This cephalad distribution reflects central mu-opioid–driven itch pathways rather than a skin-histamine reaction, so areas like the lower legs, palms, or back are not typical sites.