Journal of AdvancedMedical and Dental Sciences Research

Aim: To compare the effectiveness and safety of combining intrathecal midazolam with bupivacaine with using bupivacaine alone in subarachnoid block for cesarean delivery. Material and methods: This research included pregnant women between the ages of 20 -40 who were scheduled for an elective Caesarean section and had an ASA grade of I or II. A comprehensive history was acquired and a meticulous general and systematic evaluation was conducted. A preoperative assessment was conducted one day before the procedure. Prior to surgery, patients had a comprehensive evaluation for systemic disorders and underwent laboratory investigations including complete blood count (CBC), urine routine and microscopic inspection, kidney function tests (KFT), liver function tests (LFT), and blood sugar level (BSL) assessment. The process of administering spinal anesthesia was described to the patients, and their signed agreement was acquired. Patients were randomly divided into group B and group BM by chit method. The B group received 10 mg bupivacaine intrathecally. BM group received 10 mg bupivacaine combined with 2 mg of preservative-free midazolam intrathecally. Results: The baseline maternal parameters, including age, weight, height, pulse rate, systolic blood pressure, and diastolic blood pressure, were similar in both groups, and the difference was not statistically significant. The duration of the procedure was similar in both groups. Group BM exhibited an early start of sensory and motor block, together with an extended duration of sensory and motor block and effective analgesia, in comparison to group B. This difference was shown to be statistically significant. There were no instances when a patient did not respond well to a spinal block. The current investigation observed complications including bradycardia, hypotension, nausea, and vomiting. Group B exhibited a higher incidence of bradycardias and hypotension, while experiencing a lower occurrence of nausea/vomiting compared to group BM. However, this difference did not reach statistical significance. In the current investigation, no instances of respiratory depression, partial block, or pruritus were observed. Conclusion: The use of intrathecal midazolam with bupivacaine decreases the time it takes for sensory and motor block to occur, greatly extends the duration of pain relief, and does not lead to an increase in problems among patients having cesarean birth.