» Articles » PMID: 24729842

Reduction in Labor Pain by Intrathecal Midazolam As an Adjunct to Sufentanil

Overview
Specialty Anesthesiology
Date 2014 Apr 15
PMID 24729842
Citations 7
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Anesthesia today has strived to decrease labor pain in a tolerable and controllable fashion. Intrathecal midazolam has been introduced as an adjunct to analgesics. The study was planned to assess the efficacy, safety and duration of analgesia produced by intrathecal midazolam adjunct to sufentanil in decreasing labor pain.

Methods: In a randomized clinical trial 80 parturient included in the study. The two groups were matched for age, cervical dilation, gravid, gestational age, and other demographic characteristics. Combination of sufentanil and midazolam administered intrathecally to experimental group and compared to sufentanil group. Time to reach maximum block, and pain score was measured and recorded.

Results: Groups were matched for age and weight and other demographic characteristic. No significant adverse effect was seen in both groups including decrease in Apgar score. Duration of analgesia was 92.0 ± 12.7 in sufentanil group and 185.2 ± 15.2 minutes in midazolam and sufentanil group which was significantly different (P = 0.002). Numeric rating scale score was significantly lower in midazolam group compare to sufentanil group at 120 min (P = 0.01), 150 min (P = 0.0014), and 180 min (P = 0.001).

Conclusions: Intrathecal midazolam as an adjunct to opioid could significantly enhance analgesia in labor pain with no significant adverse effect. Intrathecal injection of midazolam is an appropriate alternative to parenteral or epidural analgesia in small hospital settings.

Citing Articles

Comparison of Fentanyl With Midazolam As Adjuvants to Levobupivacaine in Spinal Anesthesia for Cesarean Sections: A Randomized Controlled Trial.

Yazhini S, Venkatraman R, Kandan K Cureus. 2024; 16(7):e64732.

PMID: 39156298 PMC: 11329330. DOI: 10.7759/cureus.64732.


The potential value of exosomes as adjuvants for novel biologic local anesthetics.

Zhang Y, Feng S, Cheng X, Lou K, Liu X, Zhuo M Front Pharmacol. 2023; 14:1112743.

PMID: 36778004 PMC: 9909291. DOI: 10.3389/fphar.2023.1112743.


[Neuraxial labor analgesia: a literature review: a letter to the editor].

Aminnejad R Braz J Anesthesiol. 2020; 70(1):75.

PMID: 32173064 PMC: 9373238. DOI: 10.1016/j.bjan.2019.12.012.


Viscous lidocaine solution versus lidocaine spray for pharyngeal local anesthesia in upper gastroesophageal endoscopy.

Aminnejad R, Alikhani R J Res Med Sci. 2020; 25:8.

PMID: 32055248 PMC: 7003540. DOI: 10.4103/jrms.JRMS_527_19.


A comparison of the effects of ENTONOX inhalation and spinal anesthesia on labor pain reduction and apgar score in vaginal delivery: a clinical trial study.

Foji S, Yousefi Moghadam M, TabasiAsl H, Nazarzadeh M, Salehiniya H Biomedicine (Taipei). 2018; 8(3):17.

PMID: 30141404 PMC: 6108228. DOI: 10.1051/bmdcn/2018080317.


References
1.
Kim M, Lee Y . Intrathecal midazolam increases the analgesic effects of spinal blockade with bupivacaine in patients undergoing haemorrhoidectomy. Br J Anaesth. 2001; 86(1):77-9. DOI: 10.1093/bja/86.1.77. View

2.
Canavero S, Bonicalzi V, Clemente M . No neurotoxicity from long-term (>5 years) intrathecal infusion of midazolam in humans. J Pain Symptom Manage. 2006; 32(1):1-3. DOI: 10.1016/j.jpainsymman.2006.02.007. View

3.
Valentine J, Lyons G, Bellamy M . The effect of intrathecal midazolam on post-operative pain. Eur J Anaesthesiol. 1996; 13(6):589-93. DOI: 10.1046/j.1365-2346.1996.00044.x. View

4.
Minty R, Kelly L, Minty A, Hammett D . Single-dose intrathecal analgesia to control labour pain: is it a useful alternative to epidural analgesia?. Can Fam Physician. 2007; 53(3):437-42. PMC: 1949078. View

5.
Wu Y, Shiau J, Hong C, Hung C, Lu H, Tseng C . Intrathecal midazolam combined with low-dose bupivacaine improves postoperative recovery in diabetic mellitus patients undergoing foot debridement. Acta Anaesthesiol Taiwan. 2005; 43(3):129-34. View