Efficacy and potency of intrathecally administered bupivacaine and bupivacaine with midazolam in lower limb surgery at Ahmadabad, India

Abstract

Background and Aim: Many drugs have been used for spinal anaesthesia in lower limb surgery e.g. Lignocaine, bupivacaine, ropivacaine etc. Bupivacaine is still considered as a standard drug as far as therapeutic and side effect profile is concerned. The aim of present study to evaluate efficacy and potency of intrathecally administered bupivacaine and bupivacaine with midazolam on sensory and motor blockade, hemodynamic stability, side effects and post operative pain relief in lower limb surgery. Methods: A randomized controlled study was conducted on 50 patients aged 20-70 years at AMC MET Medical College, Ahmadabad, Gujarat, India. Patients were scheduled for lower limb surgeries after taking informed consent. Patients who were selected and posted for surgeries were randomly allocated in two groups. Group A received 3 ml (15 mg) hyperbaric bupivacaine 0.5% plus 0.2 ml 0.9% saline and Group B received 3 ml (15 mg) hyperbaric bupivacaine 0.5% plus 0.2 ml (1 mg) preservative free midazolam. Duration of surgery for each case was noted. Pain measurement was done using VAS scale. Results: No statistically significant difference in duration of surgery was observed between the two groups. Difference between time to onset of sensory block and time to achieve maximum block height was not statistically significant between two groups (P > 0.05) maximum level of sensory block in both groups was between T6 – T10­. Conclusion: Addition of preservative free midazolam to intrathecal bupivacaine prolongs sensory blockade and postoperative analgesia without increasing motor blockade and any adverse effects. Keywords: Ahmadabad, Anaesthesia, Bupivacaine, Midazolam, Surgery