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ORIGINAL ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 174-179

Effects of intrathecal midazolam-bupivacaine combination on postoperative analgesia


Department of anesthesia, Intensive Care and Pain Management, Faculty of Medicine for Girls Al-Azhar University, Cairo, Egypt

Correspondence Address:
Mohamed Abd-Allah Amin
Assistant Professor of Anesthesia and Intensive Care, Faculty of Medicine for Girls, AL-Azhar University, 75, Talal Mohamed Saad Allah Street, Omranya Sharqya, Giza, 12511
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_19_20

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Background and aim Subarachnoid injection of local anesthetic with midazolam potentiates spinal blockade. Midazolam is known to produce antinociception and to potentiate the effect of local anesthetic when given in the neuraxial block without significant side effects. This study was designed to assess the effects of adding midazolam to intrathecal bupivacaine in patients undergoing subumbilical surgery. Patients and methods Sixty adult patients were randomly divided into two groups: Group I was administered 3 ml of 0.5% hyperbaric bupivacaine+0.4 ml of normal saline and Group II was administered 3 ml of 0.5% hyperbaric bupivacaine+2 mg (0.4 ml) of preservative-free midazolam. Time of onset of sensory analgesia, level of sensory blockade, time for maximum cephalic spread, and motor blockade as well as vital parameters and intraoperative complications were assessed and recorded. Postoperative pain scores were assessed using the visual analog scale immediately postoperatively. Results The level of sensory blockade is higher in group II while the time of maximum cephalic spread was longer in group I. Concerning the postoperative visual analog scale, there were lower scores in group II than in group I. There was significant difference between groups I and II regarding total diclofenac sodium consumption in the postoperative 24 h with total consumption of 146.83±53.25 and 112.33±25.18 mg, respectively. The P value was found to be 0.002. Conclusion Subarachnoid injection of preservative-free midazolam as an adjuvant to intrathecal bupivacaine potentiates its effect in terms of prolonged motor and sensory blockade without any significant hemodynamic compromise or sedation and with a significant decrease of postoperative analgesic requirements.


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