الفهرس 
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Abstract
The present study was undertaken to compare the efficacy and safety of either of the fentanyl&midazolam when co-administered intrathecally with 0.5% bupivacaine in caesarean delivery. Forty Five parturient (ASA I) scheduled for elective caesarean delivery with spinal anesthesia were randomly allocated into three groups (n=15). Group B received intrathecal (IT)2 ml Bupivacaine with0. 5 normal saline, group BM received IT midazolam 2.5 mg, and group BF received IT fentanyl 25mg. Study agents were co-administered along with 2.0 ml hyperbaric bupivacaine (0.5%). The incidence of nausea-vomiting and any other adverse effects were recorded during intraoperative and early postoperative period.
The onset of surgical level were recorded where it was faster in fentanyle group.than in control group and midazolam group.
The mean total duration of analgesia were recorded where it was longer in fentanyle group, followed by midazolam group and shorter in control group.
Incidence of intraoperative and early postoperative hypotension is more in fentanyle group than in midazolam and control group.but not significantly differs
Incidence of intraoperative and early postoperative nausea-vomiting was more in controle group than fentanyle group and not occurred in midazolam group.
Adverse events caused by the study agents did not differ significantly. Intrathecal co-administration of midazolam or fentanyl significantly minimize the incidence of visceral pain intraoperatively and pain in postoperative period in caesarean section.
And decrease the requirement for analgesia during early post operative period.
Conclusion:
The present study demonstrated that addition of Fentanyl and Midazolam to Bupivacaine significantly improves the onset and duration of sensory and motor block and abolishment of the visceral pain and improve the quality of spinal anesthesia with relative haemodynamic stability, prolongs the duration of analgesia and reduce the consumption of systemic analgesics in comparison to Bupivacaine alone.
Hence, we suggest that addition of Fentanyle is excellent additive to Bupivacaine for quality of anesthesia and prolonged duration of analgesia without any deleterious effects on the mother and baby.