1887

oa Southern African Journal of Anaesthesia and Analgesia - The effect of intrathecal midazolam on the characteristics of bupivacaine spinal block and postoperative analgesia in gynaecological procedures : original research

Volume 19, Issue 2
  • ISSN : 2220-1181

 

Abstract

The present study was undertaken to determine the onset of sensory block, the time to achieve the maximum level of sensory block and the analgesic efficacy of intrathecal midazolam when given in combination with bupivacaine, and also to observe any undesirable side-effects produced by the midazolam-bupivacaine combination.


One hundred patients [American Society of Anesthesiologists (ASA) I and ASA II] aged 45-60 years and posted for elective gynaecological surgery, were randomly allocated to two groups of equal size. Group 1 (n = 50) received 12.5 mg of 0.5% hyperbaric bupivacaine with 0.4 ml of normal saline in the L3-L4 interspace, while Group 2 (n = 50) received 12.5 mg (2.5 ml) of 0.5% hyperbaric bupivacaine with 0.4 ml (2 mg) of preservative-free midazolam. Standard monitoring of haemodynamic parameters was recorded throughout the procedure.
The onset of sensory block, the time to achieve maximum sensory block and the level of block were also chronicled. The sedation scores were noted every two minutes for 20 minutes and then every 10 minutes until the end of surgery. Pain assessment was carried out according to the visual analogue scale (VAS) score. The duration of the painfree period up to rescue analgesia, or a VAS score greater than 40 mm, was documented. Unwanted side-effects were also recorded.
There was no significant difference in the demographic distribution of the patients. There was no statistically significant difference in the onset of the sensory block (p-value = 0.735) and time to achieve maximum level of sensory block in both groups (p-value = 0.45). The sedation score was comparable in both groups. There was a significantly higher duration of pain-free period in Group 2 (274.9 ± 18.07 minutes) than in Group 1 (187.2 ± 16.8 minutes) (p-value < 0.05). The number of rescue medications that were required was also significantly lower in the study group than in the controls. The number of patients who developed bradycardia and hypotension was comparable.
The addition of midazolam to intrathecal bupivacaine prolonged the duration of postoperative analgesia in this study, without affecting the onset of block and without increasing the risk of side-effects.

Loading full text...

Full text loading...

Loading

Article metrics loading...

/content/medsajaa/19/2/EJC135079
2013-01-01
2016-12-10

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error