الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Over the last several decades neuraxial labor analgesia techniques and medications have progressed, high quality pain relief with minimal side effects to both the mother and the fetus. The Intrathecal analgesia is a highly effective technique for pain relief in 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. The present study was done to offer reliable, safe pain relief to the women during normal labor, especially who require analgesia in late first stage, whose are distressed, in agony, and in need of rapid analgesia Also to compare the analgesic and clinical efficacies of intrathecal bupivacaine alone and when combined with fentanyl, clonidine, or midazolam in providing analgesia during the normal labor and comparing their effects on the newborn. One hundred twenty five patients aged18-40 years were included in the study, five patients were excluded and the remainder were equally divided into four groups(30 patients),after maternal consent, monitoring with pulse oximeter, ECG, noninvasive blood pressure and CTG, epidural catheter was inserted but not activated and intrathecal analgesia was done by using the drugs according to the group as follow: groupB ( 1.25mg bupivacaine alone), group BF(1.25mg bupivacaine+25ug fentanyl), group BC(1.25 mg bupivacaine+ 15ug clonidine) and group BM(1.25mg bupivacaine+2mg midazolam). The maternal demographic data, parity, blood pressure, heart rate respiratory rate, onset, duration, high sensory level, motor bromage scale, sedation score, the duration of the first and second stage of labor, the cervical dilation and the instrumental delivery as well as the fetal heart rate after analgesia, Apgare score, ABG, FHR changes after delivery and the fetal and maternal complications all were evaluated and discussed.