Inclusion Criteria:  Healthy women (ASA 2) Between 18 and 45 years old Singleton term pregnancies Planned neuraxial anesthesia  Exclusion Criteria:  Refusal to participate Known allergy or contraindication to any medication used in the study Significant medical or obstetrical disease (ASA ≥ 3) Opioid use disorder Chronic pain syndrome Daily or near daily opioid use within last 3 weeks. Patient receiving a Monoamine oxidase inhibitors (MOAi)