COMPARATIVE STUDY BETWEEN THE EFFECT OF INTRATHECAL BUPIVACAINE AND INTRATHECAL BUPIVACAINE-MIDAZOLAM ON POST-OPERATIVE ANALGESIA

Abstract

Background: The central neuroaxial blockade is one of the most important and most commonly used regional anesthetic techniques for lower abdominal, perineal and lower limb surgeries. Administration of combinations of drugs intrathecal targeting multiple spinal cord receptors leads to prolonged analgesia with superior quality. This can be achieved by relatively small concentrations of individual drugs. Objective: To compare the efficacy of intrathecal bupivacaine versus intrathecal bupivacaine-midazolam on post-operative analgesia. Patients and Methods: This prospective randomized study was carried out on 60 patients. They were divided into two equal groups: bupivacaine group and bupivacaine-midazolam group and compare the effect of both groups on post-operative analgesia. They were admitted to Hospital for elective lower abdominal, perineal and lower limb surgeries. The study was conducted at Al-Azhar University Hospitals, from August 2019 till July 2020. Results: The duration of post-operative analgesia was longer in the bupivacaine midazolam group (152.5 ± 20.44 minutes) compared to the bupivacaine only group (120.0 ± 31.54 minutes), but onset of sensory block was 1.55 ± 0.48 minutes in the bupivacaine only group, and 1.56 ± 0.55 minutes in bupivacaine midazolam group. There were no statistically significant differences in the two groups as regard onset of motor block, duration of motor block and there effect on postoperative nausea and vomiting. Conclusion: The addition of midazolam to bupivacaine in spinal anesthesia resulted in prolonged postoperative analgesia with no significant increase in the duration of motor block.