Original Research Article
Year: 2020 | Month: January | Volume: 7 | Issue: 1 | Pages: 433-438
Characteristics of Block and Post-Operative Analgesia of Low Dose Intrathecal Fentanyl and Midazolam Combined With Hyperbaric 0.5% Bupivacaine in Patients Undergoing Lower Limb Orthopaedic Surgeries
Vaibhav Tiwary1, Sager Punetha2
1Anesthesiology and Critical Care, Associate Professor, LLRM Medical College, Meerut.
2Anesthesiology and Critical Care, Consultant, Brijlal Hospital & Research Centre, Haldwani.
Corresponding Author: Sager Punetha
ABSTRACT
Aim: To investigate characteristics of block and post-operative analgesia of low dose intrathecal Fentanyl and Midazolam combined with hyperbaric 0.5% bupivacaine in patients undergoing lower limb orthopaedic surgeries.
Material and method: Selected consented 60 patients scheduled for orthopaedic surgeries under subarachnoid blockade were randomized into two comparable equal groups of 30 patients each i.e. Group A(Sub arachnoid block with addition of 25 μg (0.5 ml available preservative free) fentanyl to 3ml of 0.5% Bupivacaine hydrochloride (hyperbaric) and Group B: (Sub arachnoid block with addition of 1 mg (0.2 ml preservative free) midazolam (+ 0.3 ml normal saline) to 3ml of 0.5% Bupivacaine hydrochloride (hyperbaric).The motor block of the lower extremities was evaluated bilaterally by modified Bromage scale (0-3). Duration of sensory analgesia was taken from onset of spinal anesthesia to time of administration of first rescue analgesic, reflected on visual analogue scale (VAS).
Results: The mean time required to achieve Complete Sensory blockade was 142.77±8.73 sec in patients of Group A and 138.57±7.65 sec in patients of Group B.Sedation score was recorded every 30 min for 90 mins (using Ramsay sedation score) considering the time of study drug given as zero in both groups.The mean sedation score at 30 mins in patients of Group A was 2.10±0.31 and in patients of Group B it was 2.27±0.45.
Conclusion: It can be concluded that intrathecal midazolam can be used as an adjuvant to local anesthetics if fentanyl is not available or contraindicated.
Keywords: Sedation, Spinal Anaesthesia, VAS
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