“…Current opinion holds EDA as the reference standard for pain relief during labor, but compared with IV opioid analgesia it also requires more resources to implement and to manage its adverse effects (low blood pressure, loss of bladder control, itchy skin, and headache are all more common with EDA) 25 The possible adverse effects of IV fentanyl are sedation, nausea or vomiting, itchy skin, and respiratory depression. 26 In addition, the presence of additional IV lines and catheter(s) when EDA is used, compared with IV fentanyl, is likely to affect the mother's ability to follow WHO recommendations on mobility and an upright position during labor (which has been shown to reduce the need for cesarean sections). 27 Therefore, IV fentanyl may be a viable alternative, especially if a short labor is anticipated, EDA is contraindicated, or the availability of anesthetist services is limited.…”