Effect of addition of Midazolam, Fentanyl of Dexmedetomidine to 0.5% Hyperbaric Bupivacaine Given Intrathecally In Patients Undergoing Lower Abdominal & Lower Limbe Surgeries
Keywords:
Midazolam, Fentanyl, Dexmedetomidine, 0.5% Bupivacaine (H), Intrathecally, Lower abdomen & Lower limb surgeriesAbstract
Background: Various adjuvants are being used with local anaesthetics for prolongation of intraoperative and postoperative analgesia. Our research mainly focused on the additive action of 3 drugs (Midazolam, Fentanyl or Dexmedetomidine) when administered intrathecally as adjuvant to 0.5% Bupivacaine(HH). Material & Methods: 90 patients scheduled for elective lower abdominal, lower limb and gynecological procedures were selected to participate in this prospective, randomised, double blind study. All necessary ethical issues were taken off. These patients were randomly divided into three groups of 30 each by a lottery method. Patients in group BM received 3ml of 0.5% Bupivacaine (heavy) and 0.5 ml 2.5mg preservative free Midazolam (total volume made 3.5ml of drug). Patients in group BF received 3ml of 0.5% Bupivacaine (heavy) and 0.5ml 25mcg preservative free Fentanyl (total volume made 3.5ml of drug) and group BD received 3ml of 0.5% Bupivacaine (heavy) and 0.5ml 10mcg Dexmedetomidine diluted in 0.5ml distilled water (total volume made 3.5ml of drug) intrathecally. The onset and duration of sensory and motor blockade, time to reach peak sensory & motor level and the sensory and motor regression times were recorded. Results: the duration of sensory block was more prolonged than the duration of motor block and no patient complained of urinary retention in all three groups. The mean duration of onset of severe pain (VAS>7) was significantly prolonged in group BD than group BF and group BM. The duration of effective analgesia was significantly prolonged in group BD than other two groups. Conclusion: Dexmedetomidine in a dose of 10mcg is found to be more potent than Fentanyl 25mcg and Midazolam 2.5mg intrathecally with hyperbaric Bupivacaine, with less side effects and significantly prolongs the duration of postoperative analgesia.
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