COMPARISON OF INTRATHECAL FENTANYL AND MIDAZOLAM AS AN ADJUVANT TO BUPIVACAINE FOR ENHANCING THE QUALITY OF SUBARACHNOID BLOCK AND THEREBY PREVENTING NAUSEA AND VOMITING IN CAESAREAN DELIVERY

Abstract

Sucheta Meshram (Bhowate)1

BACKGROUND
The incidence of nausea, vomiting is high during an following cesarean section and is an annoying problem to all concerned. Recently, intrathecal administration of lipophilic opioids such as fentanyl and benzodiazepines like midazolam has been reported to minimise the incidences of intraoperative and early postoperative nausea and vomiting in caesarean delivery in spinal anaesthesia. They do not possess antiemetic property in their own right. They reduce these incidences by improving the quality and duration of pain relief.
MATERIALS AND METHODS
Our study was conducted to compare and to assess in a randomised single-blind placebo controlled fashion, the efficacy of 12. 5 ug intrathecal fentanyl and 2 mg intrathecal midazolam as an adjunct to bupivacaine in preventing nausea vomiting following spinal anaesthesia in caesarean section.
RESULTS
Statististical analysis revealed that intrathecal administration of fentanyl or midazolam as an adjuvant to bupivacaine are effective than bupivacaine alone in preventing nausea, vomiting following spinal anaesthesia during intraoperative and early postoperative period till 4 hours in cesarean section.
CONCLUSION
In the dose of 12.5 ug and 2 mg respectively, intrathecal fentanyl as well as midazolam equally improves the quality of anaesthesia and surgical analgesia during the surgical procedure and thereby prevent nausea, vomiting following spinal anaesthesia during cesarean section as well as in early postoperative period. They have been proved to be safe to mother and baby as well.

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