Incidence of Pruritus Using Intrathecal Fentanyl Versus Epidural Fentanyl to Initiate Labour Analgesia.

Randomized Trial Comparing the Injection of Intrathecal Fentanyl Versus Epidural Fentanyl for the Initiation of Labour Analgesia on the Incidence of Pruritis.

The purpose of this study is to investigate the effect of neuraxial analgesia initiation on the incidence of pruritus in laboring women. Specifically, this study aim to compare intrathecal fentanyl with epidural fentanyl in order to determine whether the epidural route is associated with a lower occurrence and severity of pruritus. By clarifying these differences, the research seek to optimize analgesic strategies during labor while minimizing opioid-related side effects

Inclusion Criteria:

• Age ≥ 18 years
• Vaginal delivery
• Gestational age ≥ 37 weeks
• Requesting neuraxial analgesia
• French or English language

Exclusion Criteria:

• ASA score > 3
• Allergy or contraindication to receiving opioids/local anesthesia (morphine or fentanyl)
• BMI > 40 kg/m²
• Hepatic or renal failure,
• Severe preeclampsia and signs of severity according to the criteria of the American College of Obstetricians and Gynecologists
• Maternal hemorrhage (placental abruption, hepatic subcapsular hematoma,...)
• Severe scoliosis
• Biliary cholestasis or polymorphic eruption of pregnancy
• Inability to provide informed consent, either secondary to mental or physical disability or a significant language barrier (inability to understand English or French)
• Prior administration of an opioid or opioid misuse