Cesarean delivery (CD) is one of the most common surgical procedures worldwide,1 mainly performed under spinal anesthesia. The addition of intrathecal opioids to local anesthetics for spinal anesthesia helps improve analgesia in the intra-operative and postoperative periods.2 Intrathecal morphine is recognized as a gold standard to provide a prolonged duration of postoperative analgesia.3 However, the drug has a delayed onset of action and cannot provide intra-operative analgesia.4,5 Further, there is limited availability of preservative-free morphine in developing countries, so it is common to use short-acting intrathecal opioids like fentanyl instead of morphine to enhance peri-operative analgesia after CD.
