Effect of midazolam on bupivacaine action in intrathecal anesthesia

Abstract

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.

Keywords

• Adjuvant
• hyperbaric bupivacaine
• midazolam
• subarachnoid anesthesia