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Midazolam vs. Meperidine plus Bupivacaine as spinal anaesthesia in woman undergoing caesarean surgery: clinical trial study

Background: The rate of caesarean section has risen from less than 7% in 1970s to more than 25% in 2003.

Objective: Due to the side effects of caesarean operation as well as the vital cares needed in this procedure, the raise in the ratio has expressed the technique as a matter of global concern.

Methods: A total of 93 patients’ undergone caesarean sections under spinal anaesthesia with American Society of Anaesthesiologists Class 1 and 2 were included in the study. The patients were randomly divided into three groups of 31 persons. All 3 groups received 10 mg of 0.5% bupivacaine then 25 mg of meperidine was added for the second group and 2 mg of midazolam was used for the third group while the first group received placebo in addition to bupivacaine. RM-ANOVA, chi square, and ANOVA using Bonferroni correction method we used to compare the data. All analysis was done using SPSS 20. Pvalue less than 0.05 considered as the significant level.

Results: For 10 (23.3%) subjects in the Midazolam group, 19 (61.3%) subjects in the meperidine group and 24 (77.4%) subjects in the placebo group were used anti-nausea medication. It indicates that the Midazolam group, used anti-nausea medication less than other groups (P=0.001). Immediately after spinal anaesthesia, the rate of pain was lower in the meperidine group (mean of pain score: 0.19) and it started later than other groups until 2 hours after anaesthesia. The frequency of pain was low until 3 hours after anaesthesia.

Conclusion: This investigation demonstrates that meperidine for its longer duration of analgesia is better than midazolam while with regard to having fewer side effects, the reverse is preferable. So, injecting sufficient dosage of midazolam along with bupivacaine could be a good choice for additive drug.

Author(s): Habib Zakeri, Mona Rajabi, Mehrdad Badpa, Mahshid Abdollahi, Samira Salehi, Ali Hosseinipour