Objectives:
With due attention to this matter that there is not any study which assessed the effects of intrathecal midazolam or sufentanil with bupivacaine and bupivacaine alone and its analgesia and adverse effects including respiratory depression, itching, nausea and vomiting simultaneously, so we evaluated these effects in this study.
Study Design
In a randomized clinical trial all patients who candidate for elective cesarean section with spinal anesthesia and fulfilled inclusion criteria enrolled in study. The patients divided in three groups, first group received bupivacaine 0.5% plus normal saline .9%, second group received bupivacaine 0.5% plus midazolam and third group received bupivacaine 0.5% plus normal saline and sufentanil intrathecal.
Participants, Inclusion and Exclusion criteria:
All women who are candidate for elective cesarean section enrolled in study.
Inclusion criteria: there was not any contraindication for spinal anesthesia and or any allergy to local anesthetics and other drugs which used in study, patients had not neuropathy and had written consent for spinal anesthesia. Patients with gastrointestinal disease , premature infants under 36 weeks , women who have received anti-nausea medication 24 hours before surgery , hypertension during pregnancy , and if any problems occur during cesarean section are excluded . If the patient has pain during surgery will received narcotic analgesics and excluded from study.
Interventions:
The patients were randomly divided into three groups, the first group received bupivacaine 0.5% 2.5 ml plus 1 ml of 0.9% normal saline, the second group bupivacaine 0.5% 2.5ml plus midazolam 0.02mg/kg and third group 2.5ml bupivacaine 0.5% plus 0.7cc of normal saline 0.9% and 1.5 microgram sufentanil intrathecally.
After interathecal injection in sitting position patient was immediately placed in a supine position and measures the time to reach the level of anesthesia to T10 and motor block as well. The mean arterial blood pressure and heart rate before and after anesthesia measure every 3 minutes. Apgar scores at 1 and 5 minutes after delivery evalutaed and recorded.
The main outcome variables:
Hypotension (decreasing of systolic blood pressure equal to 20%), heart rate below 45 beats per minute, nausea and vomiting, chills, itching time of T10 perception after surgery, patients need to narcotics analgesics were evaluated and recorded.