Comparative Clinical Study of 0.5% Hyperbaric Bupivacaine alone and 0.5% Hyperbaric Bupivacaine with Midazolam Intrathecally for Lower Limb Orthopaedic Surgeries
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 8
Abstract
Introduction: Subarachnoid blockade is the common form of central neuraxial blockade performed for lower limb orthopaedic surgeries. In order to maximize quality of anaesthesia and post-operative analgesia, a number of adjuvants have been added to spinal local anaesthetics. Intrathecal midazolam abolishes pain of somatic origin, produces selective sensory block, and depresses somatosympathetic reflexes without any neurotoxicity. It potentiates the blocking actions of local anaesthetics. Hence the present study is conducted to evaluate the efficacy and analgesic effect of mixture of spinal midazolam-bupivacaine as compared to bupivacaine alone in patients under going lower limb orthopedic surgery. Material and methods: The present study is conducted after ethical clearance in tertiary hospital in 100 patients aged between 18 to 60 years belonging to ASA Grade I and II of both the sexes posted for elective orthopedic surgeries. The control (B) group received 2.5mL of 0.5% hyperbaric bupivacaine plus 0.2mL of normal saline, and the preservative free midazolam group (M) received 2.5mL of 0.5% hyperbaric bupivacaine plus 1mg of midazolam in 0.2mL[preservative free]. The sensory, motor characteristics and haemodynamic variables were studied. The results were statistically analyzed using student-t test. Results: The mean time of onset of the block is reduced, the mean duration of sensory blockade is prolonged and the mean duration of analgesia is prolonged in midazolam group. No significant complications recorded. Conclusion: From the present study it can be concluded that addition of intrathecal midazolam with bupivacaine significantly improves the quality of anaesthesia, duration of analgesia without prolonging the recovery from the anaesthesia.
Authors and Affiliations
M. Venkata Ganesh, P. V. S. Lavanya
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