Comparison of efficacy of intrathecal bupivacaine plus midazolam vs bupivacaine alone for postoperatively analgesia in the patients underwent caesarean section

Abstract

Background: The aim of good postoperative analgesia is to produce a long lasting, continuous effective analgesia with minimum side effects. Adding, an intrathecal adjuvant to local anesthetics forms a reliable method to prolong the duration of anesthesia. In present study, we aimed to compare efficacy of intrathecal bupivacaine plus midazolam versus bupivacaine alone for postoperative analgesia in the patients of caesarean delivery at our tertiary care hospital. Material and Methods: The study was conducted in the department of anesthesiology in pregnant women, 20-40 years age, ASA grade I/II, posted for elective Caesarean section. Patients were randomly divided into group B (10 mg bupivacaine intrathecally) and group BM (10 mg bupivacaine combined with 2 mg of preservative-free midazolam intrathecally) by chit method. Results: During study period total 90 pregnant women were enrolled, 45 were allotted to each group B (10 mg bupivacaine) and group BM (10 mg bupivacaine combined with 2 mg of preservative-free midazolam). Baseline maternal characteristics such as age, weight, height, pulse rate, systolic BP, diastolic BP were comparable in both groups and difference was not significant. Duration of surgery was comparable in both groups. Early onset of sensory and motor block, prolonged duration sensory and motor block as well as prolonged duration of effective analgesia was noted in group BM as compared to group B, and the difference was statistically significant. No patient had failed spinal block. Complications such as bradycardia, hypotension, nausea and vomiting were noted in present study. Group B had increased number of bradycardia, hypotension and a smaller number of nausea /vomiting as compared to group BM, difference was not statistically significant. In present study respiratory depression, incomplete block, pruritus were not seen. Conclusion: Addition of intrathecal midazolam with bupivacaine, reduces the onset time of sensory and motor block, significantly prolongs duration of analgesia with no increase in the incidence of complications, in patients undergoing caesarean delivery. Keywords, postoperative analgesia, caesarean delivery, : intrathecal, bupivacaine, midazolam *Address for Correspondence: Dr Deepak Kurdukar, Assistant Professor Department of Anaesthesia Vedanta Institute of Medical Sciences Saswand,Taluka Dahanu, Dist.Palghar, INDIA. Email: [email protected] Received Date: 26/02/2020 Revised Date: 09/03/2020 Accepted Date: 21/04/2020 DOI: https://doi.org/10.26611/10151813 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.