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Intrathecal Midazolam and Nalbuphine as an Adjuvant to Bupivacaine for Infra-umbilical Surgeries

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Context: Since spinal anaesthesia provides analgesia for short time with local anaesthetics, many intrathecal adjuvants to local anaesthetic drugs have been addressed to augment the clinical efficiency and duration of anaesthesia intra & post operatively. Aims: To compare the efficacy of midazolam and nalbuphine as adjuvants in spinal anaesthesia in infra umbilical surgeries. Material and method: This study was conducted on 50 patients aged 18 to 55 years ASA I and II, randomly divided in 2 groups by chit method undergoing elective infra-umbilical surgeries under spinal anaesthesia. Group BM received 0.5% bupivacaine heavy 3 ml, 2 mg preservative free midazolam made 3.5 ml with 0.9% normal saline and Group BN received 0.5% bupivacaine heavy 3 ml, preservative free 1 mg nalbuphine made 3.5 ml with NS. Onset & duration of sensory and motor blockade, hemodynamic changes, sedative effect, time of two segment regression, duration of analgesia and requirement of rescue analgesia, side effects/complications, if any were observed. Statistical analysis: Unpaired t-test was used for statistical analysis on IBM Statistical Package for Social Sciences version 21. p-value significant if <0.05. Results: Group BM provided short onset of sensory and motor block, longer duration of anaesthesia & post-operative analgesia, sedative effect and longer two-segment regression time as compare to group BN when used as adjuvant to hyperbaric bupivacaine. Conclusion: Midazolam is better adjuvant compare to nalbuphine when used intrathecally with bupivacaine 0.5% heavy provides longer duration of anaesthesia, sedation and post operative analgesia.

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Context: Since spinal anaesthesia provides analgesia for short time with local anaesthetics, many intrathecal adjuvants to local anaesthetic drugs have been addressed to augment the clinical efficiency and duration of anaesthesia intra & post operatively. Aims: To compare the efficacy of midazolam and nalbuphine as adjuvants in spinal anaesthesia in infra umbilical surgeries. Material and method: This study was conducted on 50 patients aged 18 to 55 years ASA I and II, randomly divided in 2 groups by chit method undergoing elective infra-umbilical surgeries under spinal anaesthesia. Group BM received 0.5% bupivacaine heavy 3 ml, 2 mg preservative free midazolam made 3.5 ml with 0.9% normal saline and Group BN received 0.5% bupivacaine heavy 3 ml, preservative free 1 mg nalbuphine made 3.5 ml with NS. Onset & duration of sensory and motor blockade, hemodynamic changes, sedative effect, time of two segment regression, duration of analgesia and requirement of rescue analgesia, side effects/complications, if any were observed. Statistical analysis: Unpaired t-test was used for statistical analysis on IBM Statistical Package for Social Sciences version 21. p-value significant if <0.05. Results: Group BM provided short onset of sensory and motor block, longer duration of anaesthesia & post-operative analgesia, sedative effect and longer two-segment regression time as compare to group BN when used as adjuvant to hyperbaric bupivacaine. Conclusion: Midazolam is better adjuvant compare to nalbuphine when used intrathecally with bupivacaine 0.5% heavy provides longer duration of anaesthesia, sedation and post operative analgesia.

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This page is a summary of: A Study to Compare the Effect of Intrathecal Midazolam and Nalbuphine as an Adjuvant to Bupivacaine for Infra-umbilical Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6219.45.
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