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COMPARISON OF THE SAFETY AND EFFICACY OF INTRATHECAL BUPIVACAINE COMBINED WITH MIDAZOLAM VERSUS BUPIVACAINE FOR POSTOPERATIVE PAIN MANAGEMENT IN CAESAREAN SECTION
Keywords:
Intrathecal midazolam, Bupivacaine, Subarachnoid block, Cesarean delivery, spinal anesthesia,Abstract
INTRODUCTION: Proper postoperative analgesia is crucial for patient recovery after a lower segment cesarean section (LSCS). Adding an intrathecal adjuvant to local anesthetics is an effective method for extending the duration of anesthesia. This study was conducted to compare the effectiveness and safety of combining intrathecal midazolam with bupivacaine with using bupivacaine alone in subarachnoid block for cesarean delivery.
MATERIALS AND METHODS: The research was done in the department of anesthesiology in pregnant women aged 20-40 years, ASA grade I/II, and included 60 patients scheduled for elective Caesarean section. The patients were randomly assigned to groups B (10 mg bupivacaine intrathecally) and BM (10 mg bupivacaine mixed with 2 mg of preservative-free midazolam intrathecally) using the chit technique. Onset times of sensory and motor blockade, duration of sensory and motor blockade, and duration of effective analgesia were recorded in both the groups. Adverse effects were also monitored to evaluate the safety profile of the analgesic regimens.
RESULTS: Group BM had an earlier onset of sensory and motor block, as well as a longer duration of sensory and motor block and effective analgesia, compared to group B. The difference was found to be statistically significant. Both groups had complications such as bradycardia, hypotension, nausea, and vomiting. In comparison to group BM, group B exhibited more bradycardia and hypotension, as well as an equivalent amount of nausea and vomiting.
CONCLUSION: This study concluded that adding intrathecal midazolam and bupivacaine in subarachnoid block for patients having caesarean deliveries shortened the time it took for sensory and motor block to occur, extended its duration, and sustained analgesia without raising the risk of complications. Thus, minimal side effects are possible while yet achieving acceptable post-operative analgesia.
