Comparative Study of Intrathecal Midazolam versus Magnesium sulphate as an adjuvant to hyperbaric bupivacaine.

Dr. Ankit Singh; Dr. Neelesh Nema

Volume : VIII, Issue : VII, July - 2019

Comparative Study of Intrathecal Midazolam versus Magnesium sulphate as an adjuvant to hyperbaric bupivacaine.

Dr. Ankit Singh, Dr. Neelesh Nema

Abstract :

Background: Intrathecal drugs when used as adjuvant to spinal anaesthesia produce substantial anti-nociception and potentiate analgesia of bupivacaine. This study was planned to evaluate the effects of intrathecal non opioid drug midazolam and magnesium sulphate on duration of analgesia, characteristics of SAB and hemodynamic stability when added to 0.5% hyperbaric bupivacaine for spinal anaesthesia. Methods: Sixty ASA physical status I-II patients of age group between 20 to 60 years with elective forearm and hand surgery under achial plexus blocks were randomly allocated into two equal groups in a randomised double blind fashion. Group MZ received midazolam 2mg and Group MG received Mgso4 50mg with 15mg hyperbaric bupivacaine. The onset time and duration of sensory and motor blocks, quality of intraoperative analgesia and duration of analgesia were assessed. Results: The duration of postoperative analgesia was significantly prolonged in MZ group 391.64 (132.98) minutes as compared to MG group 252.2 (86.76) minutes (P ＜ 0.05). The numbers of analgesic doses in 24 hours were significantly less in BM group.Time of onset of sensory and motor block was significantly less in group MZ as compared to group MG (P ＜ 0.05). The duration of the sensory and motor block as well as duration of post-operative analgesia was significantly more in group BM as compared with group BMG (P＜0.05), but there was no statistically significant difference between both the groups with respect to the heart rate, mean arterial pressure and spo2. Conclusions: Intrathecal midazolam 2mg provides superior analgesia without clinically relevant side effects. The onset of analgesia was rapid and duration of sensory and motor block was prolonged with intrathecal midazolam and it also prolongs the duration of post-operative analgesia.