Journal of AdvancedMedical and Dental Sciences Research

Background and Aims: Intrathecal use of various drugs is in vogue nowadays for purpose of prolonging spinal action for postoperative analgesia. The aim of this study was to evaluate the effect of addition of midazolam to bupivacaine when administered intrathecally for lower abdominal surgeries. Methods: In the present study, a total of 100 patients of either sex in ages 20-50 years of ASA grade1 and 2 posted for various lower abdominal surgeries were recruited. All cases were randomly allocated to two groups in double blind manner. Group A (control group) received inj. Bupivacaine 0.5%  heavy 3.5 ml+ 0.4 ml normal saline intrathecally, whereas Group B (study group) received bupivacaine 0.5% heavy 3.5 ml + 0.4 ml midazolam 0.5% (2 mg) intrathecally. Onset of sensory and motor block was noted and time to achieve maximum blockade was recorded. Duration of sensory block was assessed by time taken for regression of spinal blockade to S2 segment. Degree of analgesia was assessed as 1-4 (excellent to poor), and degree of motor block assessed by Bromage scale. Vitals like pulse, BP, RR, SpO2 monitoring, and other complications like postoperative nausea and vomiting (PONV), sedation were noted. Postoperative analgesia was assessed using VAS score. Inj. Diclofenac 75 mg IM was given at VAS 5 or more as a rescue analgesic when demanded by patient. Results: Results were analyzed using standared t-test. Duration of   effective analgesia was 136.38 ±10.76 minutes in control group (Group A) and 216.60±10.71 minutes in study group (Group B) (p value< o.oo1). Adverse effects were comparable in between the two groups. Conclusion:  Addition of midazolam to bupivacaine for intrathecal use is a good alternative to improve the duration and quality of spinal anaesthesia.
Key words –Intrathecal midazolam, postoperative analgesia, spinal additives, VAS, local anesthetics, pain

Corresponding author: Dr. Maruti Pawar, Associate Professor, Dept. of Anaesthesia, R.C.S.M. Govt. Medical College, Kolhapur.
This article may be cited as: Misal U, Pawar M, Hardas D. Effect of Intrathecal Midazolam added to Bupivacaine on quality and duration of Spinal Anaesthesia in lower abdominal surgeries. J Adv Med Dent Scie Res 2017;5(11):23-28.