A Comparative Study of Intrathecal Bupivacaine and Bupivacaine with Midazolam in Lower Abdominal and Lower Limb Surgeries- a Prospective Randomised Double Blinded Study

Background & Objectives: This study was conducted to compare the differences in the onset, duration of action and complications of intrathecal hyperbaric bupivacaine 0.5% (group I) and intrathecal hyperbaric bupivacaine 0.5% with midazolam 2.5 mg (group II) in lower abdominal and lower limb surgeries Materials and Methods: Hundred patients belonging to ASA grade – I and Grade-II (each group, n=50) were randomly selected for the study. The patient and anesthesiologist administering the drug were blinded for the study.The time of onset of sensory and motor block, hemodynamic status, time for two dermatomal segments regression of sensory level , time of first request of analgesics, visual analogue score and adverse effects were compared. Results: The time of onset of sensory and motor block was significantly longer in group-II than group-I (P<0.001) Hemodynamic changes did not differ in patient of either group (P>0.05). The time for two dermatomal segments regression of sensory level (group -I 81.50±5.41 minutes and group –II 118.00± 4.80 minutes) were statistically longer in group II (P<0.001). The time of first request of analgesics by the patient in group-I was 208.00±7.55 minutes and in group II was 367.90±8.89 minutes which was statistically significant (P<0.001). The VAS scores were significantly less in group-II at 3 hours (p<0.001), 6 hours (P<0.001) and 12 hours (P<0.001) compared to group-I. The side effects were minimal in both the groups. Conclusion: Intrathecal administration of 2.5 mg of midazolam in combination with hyperbaric bupivacaine 0.5% produces better quality of analgesia, longer duration of analgesia, with mild sedation and minimal side effects thus reducing post operative analgesic requirement.. Author Affiliations: 1-3 Department of Anesthesiology, S N Medical College, Navanagar, Bagalkot, Karnataka.