Abstract

Dr. Mary Ann Linda and Dr. Nadarajan Veena*

ABSTRACT

Back ground: Pain relief is a basic human right and failure to relieve pain morally and ethically is unacceptable. The concept of postoperative pain relief and its utilization has improved dramatically over recent years. In the present study intrathecal administration of Midazolam is evaluated with respect to its analgesic properties. Methods: 60 ASA grade 1&2 patients undergoing inguinal hernia surgery under spinal anaesthesia were randamly allocated into two groups of thirty each to receive intrathecal bupivacaine with midazolam and intrathecal bupivacaine alone for post operative pain relief. Onset of sensory block to T6 level, duration of post-operative analgesia, requirement of rescue analgesic, incidence of respiratory depression, desaturation, sedation, nausea and vomiting and any incidence of neurological deficit were evaluated. Results: Midazolam group had a faster onset of action, 4.33 minutes as against 6.7 minutes in the control group. This was found to be statistically significant (p=0.000).The mean duration of analgesia in midazolam Group was 333.4minutes while in group II was 260.1minutes. This was found to be statistically significant (p=0.000) .Percentage increase in duration of analgesia was 28.18% .Requirement of rescue analgesic was less in Midazolam group compared to Bupivacaine (alone) group.There was no significant incidence of respiratory depression, desaturation, sedation, nausea and vomiting in both groups.There was no incidence of neurological deficit in either group. Conclusion: It was concluded that preservative free Midazolam can be added to Bupivacaine (0.5%heavy) for spinal anaesthesia producing optimal operating conditions and a significantly longer duration of post operative analgesia without any significant side effects.