Comparative Study between Intrathecal Fentanyl and Midazolam as Adjuvant to Local Anesthetics in Spinal Anesthesia in Elective Cesearean Section in Post-Operative Anesthesia and Post-Operative Analgesia

Abstract

ubarachnoid block achieved a wide spread popularity as a simple and effective method of anesthesia for elective cesarean sections. Among the local anesthetics, bupivacaine is the most commonly used drug for subarachnoid block. The use of intrathecal adjuvants has gained popularity, with the intention of reducing the dose of local anesthetics, maintaining hemodynamic stability, delaying the onset of pain during the postoperative period, and thus reducing the demand for postoperative rescue analgesics. Fentanyl, a short-acting lipophilic opioid, is known to augment the quality of subarachnoid block. Midazolam is an imidazobenzodiazepine with unique properties when compared with other benzodiazepines. Studies have revealed advantage of intrathecal injection of both drugs in enhancing the analgesic effect of bupivacaine after CS. This study was conducted to evaluate and compare the effects of intrathecal midazolam and fentanyl as additives to intrathecal hyperbaric bupivacaine with regards to onset and duration of sensory block, duration of complete and effective analgesia and side effects associated with the drug. This study included 90 women aged between 18-35 years scheduled to undergo elective cesarean section under spinal anesthesia. Patients were subdivided randomly into 3 groups