Improvement in postoperative pain relief by the addition of midazolam to an intrathecal injection of buprenorphine and bupivacaine

Shah, Faizan Younus; Halbe, A. R.; Panchal, Indula D.; Goodchild, Colin S

doi:10.1017/s0265021503001455

Cited by 26 publications

(22 citation statements)

References 31 publications

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“…Intrathecal midazolam 2 mg improved the quality and duration of postoperative pain relief afforded by intrathecal buprenorphine and bupivacaine. 17 Batra et al 3 reported an increased duration of postoperative analgesia with intrathecal midazolam 2mg and bupivacaine in 30 patients undergoing knee arthroscopy. All patients received rescue analgesia in the control group at a mean duration of 258 ± 46.8 min whereas only one patient in midazolambupivacaine group required supplemental analgesia within this period.3 Intrathecal midazolam 2mg provided a moderate prolongation of postoperative analgesia when used as an adjunct to bupivacaine in patients undergoing Cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

The Effect Of Intrathecal Midazolam 2.5 mg With Hyperbaric Bupivacaine On Postoperative Pain Relief In Patients Undergoing Orthopedic Surgery

2007

IJA

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In this prospective, randomized, double-blind study, we investigated the postoperative analgesic efficacy of intrathecal midazolam 2.5mg as an adjunct to bupivacaine for spinal anesthesia in 80 patients undergoing lower limb orthopedic surgery. Patients were allocated randomly to 2 groups: Group B received 3.5 ml hyperbaric bupivacaine 0.5% plus 0.5 ml saline intrathecally; group BM received 3.5 ml bupivacaine plus 0.5 ml midazolam (5 mg/ml). Mean duration of postoperative analgesia was 258±37 min in group B compared with 412±57min in group BM (p< 0.001). Supplemental analgesic dose requirement with diclofenac were significantly less in group BM (2.17 ± 0.50) compared with group B (3.00 ± 0.39) (p< 0.001). Time to onset of sensory analgesia, maximum level of sensory block, time to reach it, and time to two segment regression were comparable. We conclude that intrathecal midazolam 2.5mg provided moderate prolongation of postoperative analgesia when used as an adjunct to bupivacaine.

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Section: Discussionmentioning

confidence: 99%

The Effect Of Intrathecal Midazolam 2.5 mg With Hyperbaric Bupivacaine On Postoperative Pain Relief In Patients Undergoing Orthopedic Surgery

2007

IJA

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“…In 2003, Shah et al [38] conducted a study on intrathecal midazolam and they demonstrated augmented postoperative pain relief by the addition of midazolam to an intrathecal injection of buprenorphine and bupivacaine in patients undergoing lower abdominal surgery and adverse effects were minor and their incidence was similar in both groups.…”

Section: Human Clinical Evidencementioning

confidence: 99%

Midazolam in Subarachnoid Block: Current Evidence

Chattopadhyay

Maitra

Sen

2013

ISRN Anesthesiology

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Midazolam, despite of being the commonest benzodiazepine used in anaesthesia and perioperative care, is a relatively newer addition to the list of adjuvant used in subarachnoid block. Midazolam causes spinally mediated analgesia and the segmental analgesia produced by intrathecal midazolam is mediated by the benzodiazepine-GABA receptor complex. Initial animal studies questioned the safety of intrathecal midazolam in terms of possible neurotoxicity. However subsequent clinical studies also failed to show any neurotoxicity of high dose midazolam even on long-term use. Addition of intrathecal midazolam to bupivacaine significantly improves the duration and quality of spinal anaesthesia and provides prolonged perioperative analgesia without any significant side effects. Clinical studies also reported its safety and efficacy in pregnant women, but some studies also reported mild sedation with intrathecal midazolam. It is also reported to decrease the incidence of PONV. Intrathecal midazolam does not have any clinically significant effect on perioperative hemodynamics.

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“…Intrathecal injections of the benzodiazepine midazolam have been reported to cause antinociception and potentiate the effects of opioid analgesia. It has been concluded that 2 mg of midazolam intrathecally improves the quality and duration of postoperative pain relief provided by the intrathecal route [50].…”

Section: Desired Effectsmentioning

confidence: 99%

Intrathecal analgesic drug therapy

Farrow-Gillespie¹,

Kaplan

2006

Current Science Inc

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Improvement in postoperative pain relief by the addition of midazolam to an intrathecal injection of buprenorphine and bupivacaine

Abstract: We conclude that intrathecal midazolam 2 mg improves the quality and duration of postoperative pain relief afforded by intrathecal buprenorphine and bupivacaine.

Cited by 26 publications

References 31 publications

The Effect Of Intrathecal Midazolam 2.5 mg With Hyperbaric Bupivacaine On Postoperative Pain Relief In Patients Undergoing Orthopedic Surgery

The Effect Of Intrathecal Midazolam 2.5 mg With Hyperbaric Bupivacaine On Postoperative Pain Relief In Patients Undergoing Orthopedic Surgery

Midazolam in Subarachnoid Block: Current Evidence

Intrathecal analgesic drug therapy

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