Side Effects of Epidural Fentanyl

Opioids by  any route can cause sedation, confusion and nausea and vomiting. 

Epidural  may also cause pruritus which does not tend to respond to antihistamines such as chlorphenamine. Please contact the pain team for advice if pruritus is problematic ( Useful Contact Details within OUH).

If any of these side effects become problematic, the epidural infusate could be changed to the low dose solution which contains 0.1% bupivacaine with 2microgram/ml fentanyl.  This should be discussed with the pain team or on call anaesthetist first ( Useful Contact Details within OUH).

If there is still little improvement, the epidural infusate could be changed again to plain bupivacaine 0.125% with no opioid.  This should be discussed with the pain team or on call anaesthetist (Useful Contact Details within OUH); and other reasons for the sedation, nausea and vomiting or confusion should be considered (Confusion and Hallucinations ).