Reference

Intrathecal Midazolam II: Combination with Intrathecal Fentanyl for Labor Pain

Intrathecal Midazolam II: Combination with Intrathecal Fentanyl for Labor Pain. Tucker, Adam P.; Mezzatesta, Joseph; Nadeson, Raymond; Goodchild, Colin S. (Department of Anaesthesia, Monash Medical Centre, Victoria 3168, Australia). Anesthesia & Analgesia (Hagerstown, MD, United States), 98(6), 1521-1527 (English) 2004 Lippincott Williams & Wilkins. CODEN: AACRAT. ISSN: 0003-2999. DOCUMENT TYPE: Journal CA Section: 1 (Pharmacology) Recent investigations have sought to improve intrathecal analgesia by combining opioids with other classes of analgesics. In this study we assessed the ability of intrathecal midazolam to increase the potency and duration of the analgesic effects of intrathecal fentanyl without causing adverse effects. Thirty parturients with cervical dilations 2-6 cm were randomized to receive either intrathecal midazolam 2mg, fentanyl 10 mg, or both combined to initiate analgesia. Pain scores were recorded before and at 5-min intervals for 30 min after the injection and then every 30 min until the patient requested further analgesia. The presence and severity of nausea, emesis, pruritus, headache, and sedation, in addn. to arterial blood pressure, heart rate, respiratory rate, sensory changes to ice, motor impairment, cardiotocograph, and Apgar score were also recorded. The parturients were assessed after 2 days and 1 mo for neurol. impairment. Preinjection pain scores were unaltered by intrathecal midazolam alone and moderately decreased by fentanyl.There are some commonly used reagents with their cas registry numbers 437-38-7 and 59467-96-8 in this article. Intrathecal midazolam increased the analgesic effect of fentanyl. No treatment altered cardiorespiratory variables or caused motor impairment. The addn. of intrathecal midazolam to fentanyl did not increase the occurrence of any maternal adverse event or abnormalities on the cardiotocograph. We conclude that intrathecal midazolam enhanced the analgesic effect of fentanyl without increasing maternal or fetal adverse effects. .