Comparison of the Effect of Adding Midazolam Versus Fentanyl to Intrathecal Levobupivacaine in Patients Undergoing Cesarean Section: Double-Blind, Randomized Clinical Trial

Dr. Pratima Hansda, Dr. Bibekananda Tripathy

Abstract: Background: Spinal anesthesia is widely considered the safest, most practical anesthesia technique for cesarean delivery. Although levobupivacaine offers a stable and predictable sensory and motor block, its analgesic duration may be insufficient for extended postoperative pain relief when used alone. Incorporating intrathecal adjuvants is a proven approach to improve both the depth and longevity of spinal block. This study aims to conduct an in-depth comparison between two such adjuvants, examining how each influences block characteristics, maternal comfort, postoperative analgesia, fetal outcomes, and safety. Methods: Eighty patients were randomly assigned to two groups (n = 40). Group M received 10 mg of 0.5% levobupivacaine plus 2 mg of midazolam. Group F received 10 mg of 0.5% levobupivacaine plus 25 mg of fentanyl. Assessments included motor and sensory block, APGAR score, time to first request for analgesia, postoperative pain score, total consumption of rescue analgesics, and adverse effects. Results: Both regimens achieved satisfactory anesthesia without compromising maternal stability or neonatal health. However, notable differences emerged in sensory block duration, postoperative pain control, and side-effect patterns. One adjuvant significantly prolonged analgesia and reduced postoperative pain medication requirements, while the other produced a higher frequency of side effects. Conclusion: Intrathecal midazolam (2 mg) was superior to intrathecal fentanyl (25 mg) in increasing the duration of the sensory blockade and postoperative analgesia with lower postoperative pain scores and decreasing the incidence of adverse effects.

Keywords: Spinal anaesthesia, LevoBupivacaine, Midazolam, cesarean section, sensory block, motor block, APGAR SCORE

How to Cite?: Dr. Pratima Hansda, Dr. Bibekananda Tripathy, "Comparison of the Effect of Adding Midazolam Versus Fentanyl to Intrathecal Levobupivacaine in Patients Undergoing Cesarean Section: Double-Blind, Randomized Clinical Trial", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 1691-1694, https://www.ijsr.net/getabstract.php?paperid=MR251212161859, DOI: https://dx.doi.org/10.21275/MR251212161859