A COMPARATIVE STUDY OF THE EFFECTS OF INTRATHECAL MIDAZOLAM AND FENTANYL AS ADDITIVES TO INTRATHECAL HYPERBARIC BUPIVACAINE (0.5%) FOR SPINAL ANAESTHESIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 38
Abstract
BACKGROUND Spinal anaesthesia by 0.5% hyperbaric bupivacaine is characterised by a relatively rapid onset of action with duration of anaesthesia for approximately 3 hours and profound motor blockade. Even though it provides effective pain relief in the initial postoperative period, these patients need rescue analgesia after 3 hours. To maximise postoperative analgesia, several adjuvants, such as opioids, Clonidine, Ketamine, neostigmine, etc. have been added to spinal local anaesthetics. Preservative free midazolam is also being used as an adjuvant to prolong the duration of block. Aims and Objectives- The present study was undertaken to compare the effects of intrathecal midazolam (1 mg) and fentanyl (25 micrograms) as additives to intrathecal hyperbaric bupivacaine (0.5 %) for spinal anaesthesia. MATERIALS AND METHODS A prospective double blind randomised controlled study was carried out on 100 adult patients. Patients were randomly selected by envelope method into two groups of 50 in each. Group “BF” - Bupivacaine plus fentanyl group; Group “BM” - Bupivacaine plus midazolam group. RESULTS There were no differences in the onset and duration of sensory blockade, and durations of complete and effective analgesia, when fentanyl 25 micrograms or midazolam 1 mg was used as additive to intrathecal hyperbaric bupivacaine for spinal anaesthesia. But midazolam was associated with fewer side effects compared to fentanyl. CONCLUSION Intrathecal combination of bupivacaine and midazolam offers same advantages in terms of onset and duration of sensory blockade and durations of complete and effective analgesia with fewer side effects compared to bupivacaine and fentanyl.
Authors and Affiliations
Kurmanadh K, Srilakshmi K
Keywords
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- EP ID EP212902
- DOI 10.14260/Jemds/2017/660
- Views 87
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