The role of intrathecal midazolam as an adjunct to bupivacaine in providing post-operative pain relief

Kulkarni, Malavika and Kurdi, Madhuri and Sujatha, DA and Kulkarni, Muralidhar M (2012) The role of intrathecal midazolam as an adjunct to bupivacaine in providing post-operative pain relief. International Journal of Health & Allied Sciences, 1 (4). pp. 231-234. ISSN 2278-4292

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Abstract

Context: Post-operative analgesia forms an essential ingredient of perioperative care. Various adjuvants which include opioids and non-opioids have been used to prolong the post-operative analgesia of intrathecal bupivacaine. Aim: The study was conducted to study the effect of intrathecal midazolam in prolonging post-operative analgesia when used as an adjunct with bupivacaine. Settings and Design: The present study was a randomized control design conducted at Karnataka Institute of Medical Sciences, Hubli, Karnataka, India. Materials and Methods: A prospective randomized double blind placebo controlled study was undertaken to evaluate the efficacy of intrathecal midazolam as an adjunct intrathecal bupivacaine for post-operative analgesia on 150 adult patients of ASA grade I/II scheduled to undergo elective lower abdomen, lower limb, and urological surgeries. Patients in group A (n = 75) received 3 ml of intrathecal heavy bupivacaine with 0.2 ml of saline. In group B, patients received 3 ml of intrathecal heavy bupivacaine with 0.2 ml of preservative free 1 mg of midazolam. Statistical Analysis: Mean, Standard Deviation (SD), Z test, Chi-square test were done. Data was analyzed using Pc (XT) with minitab software version 13. Results: There was no significant difference observed in both the groups with respect to onset of sensory block, time taken to achieve maximum sensory block, or level of sensory block. The duration of sensory block was significantly longer in group B than group A (266.36 ± 22.56 min vs 187.8 ± 22.92 min). The duration of effective analgesia was prolonged in midazolam group than in the control group (232.75 ± 21.44 min vs 133.83 ± 16.23 min) with a P value <.0001. Conclusion: The duration of effective analgesia when midazolam is added to intrathecal bupivacaine is significantly prolonged thereby proving that midazolam is a useful adjunct to intrathecal bupivacaine for post-operative analgesia.

Item Type: Article
Uncontrolled Keywords: Adjuvant; bupivacaine; intrathecal; midazolam; post operative analgesia.
Subjects: Medicine > KMC Manipal > Anaesthesiology
Medicine > KMC Manipal > Community Medicine
Depositing User: KMC Manipal
Date Deposited: 21 Aug 2013 10:10
Last Modified: 30 Sep 2016 16:12
URI: http://eprints.manipal.edu/id/eprint/136861

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