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

Abstract

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.