title: Efficacy of intrathecal midazolam in potentiating the analgesic effect of intrathecal fentanyl in patients undergoing lower limb surgery.
abstract: BACKGROUND
  The intrathecal administration of combination of drugs has a synergistic effect on the subarachnoid block characteristics. This study was designed to study the efficacy of intrathecal midazolam in potentiating the analgesic duration of fentanyl along with prolonged sensorimotor blockade.
  
  
  METHODS
  In a double-blind study design, 75 adult patients were randomly divided into three groups: Group B, 3 ml of 0.5% hyperbaric bupivacaine; Group BF, 3 ml of 0.5% hyperbaric bupivacaine + 25 mcg of fentanyl; and Group BFM, 3 ml of 0.5% hyperbaric bupivacaine + 25 mcg of fentanyl + 1 mg of midazolam. Postoperative analgesia was assessed using visual analog scale scores and onset and duration of sensory and the motor blockade was recorded.
  
  
  RESULTS
  Mean duration of analgesia in Group B was 211.60 ± 16.12 min, in Group BF 420.80 ± 32.39 min and in Group BFM, it was 470.68 ± 37.51 min. There was statistically significant difference in duration of analgesia between Group B and BF (P = 0.000), between Group B and BFM (P = 0.000), and between Group BF and BFM (P = 0.000). Both the onset and duration of sensory and motor blockade was significantly prolonged in BFM group.
  
  
  CONCLUSIONS
  Intrathecal midazolam potentiates the effect of intrathecal fentanyl in terms of prolonged duration of analgesia and prolonged motor and sensory block without any significant hemodynamic compromise.
authors.affiliation: Department of Anaesthesia, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Anshu
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesia, Pramukhswami Medical College, Anand, Gujarat, India.
authors.forename: Hemlata
authors.initials: H
authors.lastname: Kamat
authors.affiliation: Department of Anaesthesia, Pramukhswami Medical College, Anand, Gujarat, India.
authors.forename: Utpala
authors.initials: U
authors.lastname: Kharod
keywords: Analgesia; fentanyl; intrathecal; midazolam