الفهرس 
Regional Anesthesia And Caesarean sectionOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Addition of intrathecal fentanyl or midazolam to bupivacaine enhances afferent sensory blockade and improves the duration of local anaesthetic action. The objective of this study was to compare the effect of intrathecal fentanyl with that of intrathecal midazolam in combination with bupivacaine on the duration and quality of spinal blockade in caesarean section.
Patients and Methods: In this study, both patients were blinded to patient group assignment. One hundred and fifty patients between the ages of 18-40 years scheduled to undergo elective caesarean section surgery were enrolled for the study. Patients were randomly divided into three groups:
1) Bupivicaine group (2 ml of 0.5% hyperbaric bupicavaine with 0.5 ml normal saline 0.9%.
2) Bupivicaine and fentanyl group (2 ml of 0.5% hyperbaric bupicavaine with 0.5 ml fentanyl corresponds to 25 μg fentanyl).
3) Bupivicaine and midazolam group ( 2 ml of bupivicaine and 0.5 ml of midazolam preservative free corresponds to 2.5 mg)
Duration of sensory and motor blockade was assessed. In addition, other
characteristics of the block, duration of effective analgesia, postoperative nausea and vomiting, hemodynamics( introperative and postoperative) and side effects were also noted.
Results: Mean time taken for regression of the block and mean duration of motor block were both significantly longer with midazolam ( 435 ±15.9 minutes) than with fentanyl group (397 ± 20 minutes) with comparison to the least time in sensory regression in bupivicaine alone group (264 ± 15 minutes) (p<0.05).
Conclusion: Intrathecal midazolam in combination with bupivacaine provides a longer duration of sensory and motor blockade as compared to Fentanyl added to bupivicaine for elective caesarean section, with no great difference in postoperative nausea and vomiting.