Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective Cesarean Section; a randomized controlled double-blind trial

Background: Different adjuvants have been introduced to enhance the quality of local anesthetics and reduce its adverse events. This study was directed compare anesthetic analgesic properties intrathecal hyperbaric bupivacaine when three different adjuvant drugs were added.
 Methodology: One hundred full-term parturients aged 18 40 years, scheduled for elective cesarean section, randomly assigned 4 groups. Each group received 12.5 mg 0.5% combined with either 0.5 ml saline (Group-B), 25µg fentanyl (Group-F), 0.8 nalbuphine (Group-N) or 2 midazolam (Group-M). The outcomes included postoperative effective analgesia time, sensorimotor characteristics, VAS score, pethidine consumption, maternal complications, neonatal Apgar score.
 Results: Earlier onset sensory motor block observed in Group F N than B M. Duration longer Groups F, M (252.42 ± 46.11, 227.34 36.54 243.71 44.95 hours, respectively) (172.11 20.99) (P < 0.001). scores decreased groups during first 12 hours required doses less.
 Conclusion: Addition agents improved subarachnoid without increasing side-effects. Intrathecal provided comparable as frequently used opioids.
 Abbreviations: CS: Cesarean section; LA: Local anesthetics; SA: Spinal anesthesia
 Key words: Intrathecal; Nalbuphine; Midazolam; Fentanyl; Postoperative analgesia; section.
 Citation: Amin SR, Souidan I, Abdelzaam EM. is a alternative spinal anesthesia section: randomized controlled double-blind trial. Anaesth. pain intensive care 2022;27(1):89−96; DOI: 10.35975/apic.v27i1.1923
 Received: June 26, 2022; Reviewed: November 28, Accepted: December 14, 2022