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Pain is a complex medical issue. Lack of postoperative pain relief adversely affects the physiological, metabolic and mental conditions of patients. Duration of analgesia could increase by using additional supplements. This study aimed to compare the effects of intrathecal midazolam and tramadol with the conventional method of postoperative pain and shivering control after elective cesarean section. This double-blind randomized clinical trial was conducted on 210 women aged 20-35 years with ASA class I and II who were candidates for elective cesarean section. Subjects were randomly divided into three groups of midazolam, tramadol and control to receive hyperbaric lidocaine and midazolam (2 mg), tramadol (25 mg), and normal saline (5 cc), respectively. Using the visual analogue scale (VAS), postoperative pain score and analgesia duration were assessed and compared between the groups. Moreover, scores of shivering during and after the surgery were compared between the groups. According to the results of Kruskal-Wallis, mean score of postoperative analgesia duration was significantly higher in the tramadol group compared to the other groups, while it was higher in the midazolam group compared to control subjects (P<0.001). Moreover, mean consumed dose of analgesics at 24 hours after surgery was significantly lower in the tramadol group compared to the other groups, while it was significantly lower in the midazolam group compared to control subjects (P<0.001). At different time intervals, postoperative shivering was significantly lower in the tramadol group compared to the other groups, while it was significantly lower in the midazolam group compared to control subjects (P<0.01). According to the results of this study, intrathecal midazolam and tramadol supplementary to lidocaine 5 could increase analgesia duration and reduce postoperative shivering after cesarean section, and midazolam was more effective than tramadol in this regard.

biomedical and pharmacology journal/biomedical and pharmacology journal

Comparison of the Effects of Intrathecal Midazolam and Tramadol with the Conventional Method of Postoperative Pain and Shivering Control after Elective Cesarean Section