HBOT Conversations:

Pruritus is a troublesome side-effect of neuraxial (epidural and intrathecal) opioids.
Sometimes it may be more unpleasant than pain itself. The incidence of pruritus is 83% in
postpartum patients and 69% in non-pregnant patients including males and females (1). Some
researchers concluded that slow injection rate of hyperbaric bupivacaine may be a simple and
effective way to reduce the incidence and severity of hypotension during cesarean section
under spinal anesthesia (2). In this new research I want to investigate the effect of slow
injection of fentanyl separately, in spinal anesthesia for cesarean section, on the incidence
of itching In this double blind randomized study two hundred parturient will be randomly
allocated in to two groups; Group (R) will receive 25 mic fentanyl spinal ( after dilution
with 2.5 ml CSF) in 15 seconds. Group (S) will receive the same dose in 90 seconds All
parturient will receive 10 mg bupivacaine in 45 min after fentanyl. Exclusion criteria will
be those with allergy to any medications, contraindications to spinal anesthesia, those who
requested sedation, presence of skin lesions that may cause itching and opioid addiction.

Parturient will be monitored regarding the incidence of itching, hypotension, nausea and
vomiting. Onset and level of sensory block will also be recorded.