[Effects of intravenous midazolam, fentanyl or ketamine on pain relief during performance of epidural anesthesia].

Background: Performing epidural anesthesia is accompanied by pain. The aim of this study is to examine whether intravenous administration of a sedative, an opioid, or an anesthetic eliminates pain score during the epidural procedure.
Methods: Two-hundred and fifty-nine patients undergoing epidural anesthesia were randomly allocated into six groups. Prior to the epidural anesthesia, midazolam, fentanyl, ketamine, midazolam plus fentanyl or midazolam plus ketamine was given intravenously to the patients in each group. After the procedure, the effects of these drugs on pain relief in the patients were assessed by visual analogue scale(VAS).
Results: VAS was significantly decreased in all drug-treated groups to a similar extent, as compared with drug-free group. There was no significant difference between the drug-treated groups. Serious side effects including persistent respiratory suppression were not observed in this study.
Conclusions: The findings obtained from this study suggest that the analgesic action of the drug is not essential to the pain relief and the anxiolytic action is important for the epidural procedure.