Expert: Dr Ian Jackson - please note UK based - 3/15/2009

Question
Dear Dr.,I have had three spinal injections with fentanyl as one of the drugs. The first time, I had mild itching which was attributed to the type of gown I was wearing. The second time it was more intense and the nurse said it was probably a reaction to fentanyl and I was given benadryl,which helped. For the 3rd shot, the gave me benedryl before with fentanyl. The next year, I had a breast lumpectomy and when I gave him my history, the anesthesiologist told me to avoid fentanyl and he gave me something else. Yesterday, I had surgery for carpal tunnel and the nurse anesthetist said my description of what happened previously was a reaction rather than allergy and that fentanyl was the drug of choice for my procedure, but she would try to "AVOID" using it if she could. Am I allergic to fentanyl or not? Should I avoid it? I remember being uncomfortable those first few times because the itching was intense... Thanks
Sara  

Answer
Sara
Most opioids like fentanyl cause itching as a 'side effect' and this is not an allergy. This is especially true when they are given spinally and many people feel this. I would therefore agree with the nurse who said you were unlikely to be allergic to fentanyl.
Kind regards
Dr Ian Jackson