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    International Journal of Innovative Science and Research Technology
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    Spinal anaesthesia is the most commonly used regional anaesthetic technique.

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    Assessment of Efficacy of Midazolam as an Adjuvant to Intrathecal Bupivacaine for Lower Abdominal Surgeries

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    Spinal anaesthesia is the most commonly used regional anaesthetic technique.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    8 views2 pages

    Assessment of Efficacy of Midazolam As An Adjuvant To Intrathecal Bupivacaine For Lower Abdominal Surgeries

    Uploaded by

    International Journal of Innovative Science and Research Technology
    Spinal anaesthesia is the most commonly used regional anaesthetic technique.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology

    ISSN No:-2456-2165

    Assessment of Efficacy of Midazolam as an


    Adjuvant to Intrathecal Bupivacaine for Lower
    Abdominal Surgeries
    Dr. Kottam Surekha. Post Graduate, Dr. Shaik Mohammed Ghiyazuddin, Assistant professor,
    Department of Anesthesiology, Kurnool Medical College Department of Anesthesiology, Kurnool medical college
    Kurnool, Andhra Pradesh. Kurnool, Andhra Pradesh.

    I. INTRODUCTION

    Spinal anaesthesia is the most commonly used regional


    anaesthetic technique. Local anaesthetic agents used for this
    purpose provide good intraoperative analgesia. However,
    they provide a very limited postoperative duration of action.
    In order to overcome this problem and to maximise the
    duration of anaesthesia-analgesia, many adjuvants, such as
    intrathecal opioids and non-opioids, have increasingly been
    tried in the last two decades to relieve postoperative pain.

     Aims & Objectives


    Bupivacaine when used alone produces analgesia for
    2.5 to 3 hours, making it unsuitable in cases where the
    duration of surgery is longer and in cases which require
    further analgesia during post-operative period. Present study
    is intended to evaluate the effect of addition of intrathecal
    midazolam to bupivacaine to prolong the post-operative
    analgesia.

    II. METHODOLOGY Fig 2 Summary Results

    A prospective randomized double-blind study was Both groups did not differ significantly as regard to
    carried out on 60 adult ASA gr 1 and 2 pts, to compare the time of onset of sensory block, duration of action, time for
    efficacy of intrathecal bupivacaine with midazolam and regression of sensory block to T12. There was significant
    bupivacaine alone for post operative pain relief. Pts were duration of post operative analgesia observed in group BM.
    randomly divided into 2 groups. Group B {n=30} received There were no episodes of bradycardia, hypotension,
    3ml of 0.5% bupivacaine with 0.2 ml of 0.9% normal saline. sedation, intraoperatively or postoperatively and no
    Group BM{n=30} received 3ml of 0.5% bupivacaine with vomiting, pruritis and urinary retention in post operative
    0.2 ml of preservative free midazolam. period.

    III. DISCUSSION

    Our study shows that the addition of midazolam to


    intrathecal bupivacaine significantly prolongs the duration
    of postoperative analgesia. The time to first rescue analgesic
    was more than 16 hrs in BM group as compared to 3.5 hrs in
    B group. Antinociceptive action are mediated via
    BZD/GABA-A receptor complex which are present in
    lamina 2 of dorsal horn ganglia of spinal cord Intrathecal
    midazolam probably causes release of an endogenous opioid
    acting at spinal delta receptors as naltrindole. Intrathecal
    midazolam besides causing analgesia has also been found to
    be effective in suppressing reflex response to visceral
    distention and its pain. Intrathecal midazolam has been
    shown to be free of any neurotoxicity and other side effects
    Fig 1 Demographic Profile Chart with dose up to 2mg.

    IJISRT23FEB379 www.ijisrt.com 586


    Volume 8, Issue 2, February – 2023 International Journal of Innovative Science and Research Technology
    ISSN No:-2456-2165
    IV. CONCLUSION

    Intrathecal midazolam added to bupivacaine prolongs


    duration of post op analgesia without prolonging the
    duration of dermatomal sensory block with no side effects.

    REFERENCES

    [1]. Valentine MJ, lyons G bellemy MC.the effect of


    intrathecal midazolam on post op pain. j of
    anaesthesia 1996 13:589-593.
    [2]. Edwards m, Serrao. mechanism by which midazolam
    causes spinally mediated analgesia. anaesthesiology
    1990-73,273,77.
    [3]. Indian j, anaesthesia 2005; 49(1);37-39 effect of
    intrathecal midazolam bupivacaine combination on
    post op analgesia.

    IJISRT23FEB379 www.ijisrt.com 587

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