Evaluation of analgesic efficacy and safety of intrathecal midazolam as an adjuvant to bupivacaine
Dr. Neetu Gupta, Dr. KK Arora, Dr. Shailendra Singh, Dr. SR Laad
Background: Subarachnoid block (SAB) is the commonest mode of anaesthesia for the lower limb and lower abdominal surgeries. The main disadvantage of SAB is its limited duration of action. To overcome this limitation various adjuvants are added to spinal local anaesthetics. In this present study we evaluated the efficacy and safety of midazolam as an adjuvant to intrathecal bupivacaine for lower limb and lower abdominal surgeries. Methods: 60 patients of either sex in the age group of 20 to 50 years belonging to ASA class 1 or 2 scheduled for elective/emergency lower abdominal or lower limb surgeries were enrolled for the study and randomly divided in to two groups. Group C (control group) received 3ml of 0.5% (heavy) bupivacaine + 0.4ml of normal saline (0.9%) and Group M (study group) received 3ml of 0.5% (heavy) bupivacaine + 0.4 ml (2mg) of midazolam in SAB. Heart rate, blood pressure, respiratory rate, onset of sensory and motor blockade, visual analogous scale (VAS) at different time intervals postoperatively, duration of analgesia and duration of motor blockade were recorded. Result: In both the groups onset of sensory and motor blockade were comparable (P>0.05). Mean VAS at different time interval during postoperative period was significantly lower in group M (P<0.001) than group C. The duration of postoperative analgesia (P <0.001) and the duration of motor blockade (P<0.01) was significantly prolonged in group M as compared to group C. Conclusion: Midazolam as an adjuvant to intrathecal bupivacaine significantly prolongs the duration of postoperative analgesia without any side effect.