Spinal anaesthesia is preferred for lower abdominal and lower limb surgeries especially in cesarean sections due to long duration of analgesic effect, lesser thromboemolic events, because it is economical, easy to administer and fewer adverse effects in mother and infant. Bupivacaine is the most popular local anaesthetic for subarachnoid blockade because of less neurotoxicity. Intrathecal bupivacaine alone may be insufficient to provide prolonged post-operative analgesia, even with high sensory block. So, various adjuvants are used like ketamine, midazolam, clonidine, fentanyl, neostigmine etc. to prolong the effect of local anaesthetic. Fentanyl, an opioid, after intrathecal administration diffuses into epidural space and subsequently into the plasma, suggesting that it acts not only through spinal opioid receptors but also systemically. Fentanyl added to bupivacaine intrathecally provides better surgical anaesthesia.  Midazolam, a benzodiazepine is an anxiolytic and sedative, it when administered intrathecally has antinociceptive properties.

PRIMARY OBJECTIVE: COMPARISION OF DURATION OF ANALGESIA BETWEEN FENTANYL AND MIDAZOLAM AS AN ADJUVANT WITH BUPIVACAINE.

SECONDARY OBJECTIVE:

1. Compare the effect of fentanyl and midazolam on intraoperative haemodynamics. 

2. The Onset and Duration of Sensory And Motor Block . 

3. To compare the role of fentanyl and midazolam as an adjuvant for prevention of side effects like nausea, vomiting, shivering, pruritis. 

4. To access APGAR score.

METHODOLOGY: Patients for the study will be conducted on 60 patients fulfilling the inclusion criteria. Patients will be randomly allocated into 2 study groups who will be administered with the following combination of drugs.

GROUP A (n=30): 15 mcg Fentanyl intrathecal (0.3ml) with 2ml 0.5% Bupivacaine

GROUP B (n=30): 0.3 mg Midazolam intrathecal (0.3ml) with 2ml 0.5% Bupivacaine and the onset of duration of sensory and motor blockade , hemodynamic parameters, post operative analgesia and side effects will be recorded.