Abstract :
Background: Increasing the duration of action and maximizing postoperative analgesia
has always been a domain of interest in spinal blocks. Many adjuvants have been tried
along with local anaesthetic agent to achieve the same. The following study was
conducted to compare sensory and motor characteristics with 2mg midazolam in
subarachnoid block. Aim: To evaluate the efficacy and analgesic effect of the mixture
of 2 mg midazolam and 15 mg (3 ml) hyperbaric bupivacaine as compared to
bupivacaine alone in patients undergoing infra-umbilical surgery under spinal block.
Material and Methods: In this observational prospective case control study 100
patients (ASA class I and II), aged 18 to 55 years, undergoing elective infra -umbilical
surgeries under spinal block were randomly divided into Group I- patients were
administered 0.5% hyperbaric Bupivacaine (3 ml) + 0.9% Normal saline (0.4 ml)
intrathecally and Group 2- patients were administered 0.5% hyperbaric Bupivacaine (3
ml) + 2mg preservative free Midazolam (0.4 ml) intrathecally. The onset and duration
of sensory and motor block, hemodynamic variables, and side effects during the
surgery and recovery were compared among the groups. Results: 2mg of preservative
free midazolam used as an adjuvant to bupivacaine intrathecally reduces onset time of
sensory and motor blockade, also time taken to reach T-10. It also increases time taken
for two segmental recession and mean duration of analgesia. Conclusion: It can be
inferred that Inj. Midazolam 2 mg in combination with Inj. bupivacaine 0.5%
hyperbaric can be safely administered intrathecally for better postoperative
analgesia.
Keyword :
Intrathecal Midazolam, Post-operative Analgesia, Bupivacaine, Spinal Anesthesia.