Intrathecal labor analgesia by using bupivacine alone or combined with fentanyl, midazolam or clonidine

Background The Intrathecal analgesia is a highly effective technique for pain relief in the first stage of labor. Its effectiveness, simplicity, and low incidence of serious complications, less motor blockade and decrease the rate of cesarean section, make it applicable to the physicians Methods: one hundred twenty patients were equally divided into four groups where epidural catheter was inserted but not activated and intrathecal analgesia was done by using the drugs according to the group as follow: groupB ( bupivacaine alone), group BF( bupivacaine + fentanyl ) , group BC(bupivacaine+clonidine) and group BM(bupivacaine+midazolam) Results: there were slight decrease in blood pressure, heart rate ,respiratory rate and significant difference in the onset, duration and VAS, also there was slight decrease in fetal heart rate after analgesia with significantly low apgare score at 3 minuts post delivery with clonidine group, insignificant difference in sensory level, bromage and sedation scores. the post operative side effect for the mother and the fetus showed insignificant difference except for nausea and pruiritis with fentanyl group. Conclusion: the intrathecal analgesia was very simple, easily applicable, and highly satisfactory for the patient with reliable analgesia, the bupivacaine and fentanyl group had effective analgesia with rapid onset, long duration with minimal side effects on the mother in form of nausea and pruiritis