A COMPARATIVE STUDY OF INTRATHECAL BUPIVACAINE WITH FENTANYL AND BUPIVACAINE WITH MIDAZOLAM IN LOWER ABDOMINAL AND LOWER LIMB SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 46
Abstract
BACKGROUND Various adjuvants are being used with local anaesthetics in spinal anaesthesia for prolongation of intraoperative and postoperative analgesia. Fentanyl is a lipophilic µ receptor agonist opioid, neuraxial adjuvant compared with Midazolam, Benzodiazepine used as Neuraxial adjuvant with Bupivacaine. Aim- To compare and evaluate the onset and duration of sensory and motor blockade, Haemodynamic effect, post-operative Analgesia and adverse effects of fentanyl and Midazolam given intrathecally with hyperbaric 0.5% bupivacaine. MATERIALS AND METHODS 100 patients belonging to ASA Grade-I and Grade-II of both sexes (each group 50 patients, n= 50) were selected for the study. Group-F received 3 mL of 0.5% Hyperbaric Bupivacaine with 0.5 mL (25 micrograms) of Fentanyl. Group-M received 3 mL of 0.5% hyperbaric Bupivacaine with 0.5 mL (25 mg) of Midazolam. The time onset of sensory and motor block, Haemodynamic status, time for two dermatomal segments regression of sensory level to L2 dermatome, time of first request of analgesics, visual analgesic score and adverse effect were compared in both the groups. Data obtained were tabulated and analysed using statistical package for social science (SPSS 16.0 evaluation version). Descriptive data are presented as mean ± SD. The difference between variables were calculated by student’s ‘t’ test and chi square test at 5% level of significance. RESULTS Patients in Fentanyl group (Group F) had a significantly longer sensory and motor block than patients in Midazolam group (Group M). The mean time of sensory regression to L2 was (172.30 ± 5.08 min) in Group F and (147.30 ± 8.71 min) in Group M. The regression time of motor block to reach Bromage 0 was (201.20 ± 29.63 min) in Group F and (183.20 ± 5.88 min) in Group M. The time to rescue analgesia was significantly longer in Group F (381.67 ± 38.9 min) as compared to Group M (226.67 ± 15.2 min). CONCLUSION Intrathecal administration of 25 microgram of fentanyl in combination with hyperbaric Bupivacaine 0.5% produces better quality of Analgesia, longer duration of Analgesia with mild sedation and minimal side effects compared to Intrathecal administration of 2.5 mg of Midazolam in combination with hyperbaric Bupivacaine 0.5%
Authors and Affiliations
Holalu Shankaregowda Suraj, Vinod C. N
Keywords
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- EP ID EP217340
- DOI 10.14260/Jemds/2017/768
- Views 52
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