Effect of midazolam on bupivacaine action in intrathecal anesthesia

• Published in: Medical Journal of Babylon 2018, Vol.15 (1), p.43-47
• Main Authors: Ajam, Anas Amir M., Guri, Ramadan Jafar
• Format: Article
• Language: English
• Subjects: Adjuvant; Bupivacaine; Cesarean section; Complications and side effects; Dosage and administration; hyperbaric bupivacaine; Midazolam; Nerve block; Patient outcomes; subarachnoid anesthesia
• ISSN: 1812-156X; 2312-6760
• DOI: 10.4103/MJBL.MJBL_12_18

Background: Subarachnoid anesthesia is regarded as one of the famous neuroaxial block procedures available nowadays. Neuraxial anesthesia offers many benefits over general anesthesia. Objective : This study is designed to compare the effect of adding 1 and 2 mg midazolam to hyperbaric bupivacaine on duration of sensory and motor block and intraoperative hemodynamic changes for the cesarian section under subarachnoid anesthesia. Methods : Ninety patients with the American Society of Anesthesiology Classifications I/II (range : 18–40 years) were randomly allocated into three groups and were underwent spinal anesthesia for Cesarean Section in Duhok Maternity Hospital, Iraq. Group A (n = 30) received intrathecal of bupivacaine 12.5 mg + 0.4 ml of normal saline, Group B (n = 30) intrathecal of bupivacaine 12.5 mg + 1 mg midazolam, and Group C (n = 30) intrathecal of bupivacaine 12.5 mg + 2 mg midazolam. The study groups were comparable in age and hemodynamic status changes prior and intra-intervention commencement. Results: The analgesic duration of those patients in Groups C and B were significantly longer, 183.33 and 181.00 min compared to 138.00 min in Group A for motor block (P < 0.0001) and 212.00, 210.00, and 142.00 min, respectively, for sensory block (P < 0.0001) with no any substantial difference in hemodynamic status changes. Conclusion : The longer duration of analgesic was found using midazolam adjuvant with bupivacaine compared to free adjuvant group in women underwent spinal anesthesia.