Comparative evalution of intrathecal 0.5% heavy bupivacaine alone with intrathecal preservative free midazolam(1.5mg) and 0.5% bupivacaine combination in inguinal hernia surgery
Journal Title: MedPulse -International Medical Journal - Year 2015, Vol 2, Issue 12
Abstract
Background: Spinal Anaesthesia is a common anaesthetic technique for inguinal hernia surgery. Many adjuvents have been added intrathecally along with local anaesthetic and their effects are evaluated. Midazolam has been evaluated and found that it prolongs the duration of analgesia along with intraoperative sedation. In the present double blind prospective study we compare the study of 0.5% hyperbaric Bupivaccaine intrathecally alone (Group B) with 0.5% hyperbaric Bupivaccaine Midazolam combination intrathecally (Group BM) in patients undergoing elective ingunal hernia surgery. Methods: 100 patients of ASA GradeI\II aged 18-55 years were randomly allocated into 2 groups (50 each) Group B received 0.5%Bupivaccaine 2.6ml +0.3ml normal saline intrathecally and Group BM received 0.5% Bupivaccaine 2.6ml +0.3 ml Midazolam preservative free(1.5mg).We observed the onset of sensory anaesthesia (L1level), peak sensory level, duration of sensory and motor block, two point regression time, intraoperative sedation score time for first dose of Rescue analgesia along with vital parameters Heart Rate, Systolic and Diastolic Blood Pressure, SPO2, and Respiratory Rate. Results: The time for first rescue analgesia was significantly prolonged in Group BM (390 ± 79.02 minutes) vs in Group B(271.6 ± 40.76 minutes) P value < 0.0001, highly significant.. Intraoperative sedation score was more in Group BM(2.46 ± 0.76) as compared to GroupB(2.08 ± 0.72) and statistically significant. Conclusion: Addition of intrathecal Midazolam (1.5 mg preservative free) to Bupivacaine 0.5% (heavy) significantly prolong the duration of effective analgesia which is reflected as the time to request for first rescue analgesia, along with significant sedation score in GroupBM,and No adverse effects occurred in the form of respiratory depression, pruritis, nausea, vomiting, urinary retention and neurological deficit.
Authors and Affiliations
Ramesh N Sugandh, Sneha Khobragade, Naresh G Tirpude
Keywords
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