Fentanyl with Midazolam as an Adjuvant to Intrathecal Bupivacaine in Lower Limb Surgeries

  • Sunil Kuldeep SMS Medical College and Hospitals, Jaipur, Rajasthan, India
  • Malkhan Singh SMS Medical College and Hospitals, Jaipur, Rajasthan, India
  • Sunil Chauhan SMS Medical College and Hospitals, Jaipur, Rajasthan, India
  • Siddharth Sharma SMS Medical College and Hospitals, Jaipur, Rajasthan, India
Keywords: Adjuvant,, Analgesia, Fentanyl, Intrathecal, Midazolam, Prolonged


Introduction: Coadministration of drugs with synergistic effects considered one of the methods to increase the effectiveness of analgesia. The aim of this study is to evaluate the efficacy of midazolam to potentiate the analgesic effect of fentanyl as an adjuvant to bupivacaine.
Materials and Methods: This is a hospital based prospective, randomized, double-blind interventional control study conducted at SMS medical college and hospitals, Jaipur. A total of 90 patients were enrolled in the study. They were allocated into three groups, 30 in each. A total of 3.7 ml study drugs injected in each group. Intraoperative monitoring of hemodynamic parameters, duration of surgery, onset of sensory and motor block, duration of analgesia, sensory and motor block, and incidence of adverse effects was done and compared.
Results: There was no significant difference in mean pulse rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure (P > 0.05). The mean duration of surgery in Group A, B, and C was 101.3 ± 13.08, 92.93 ± 15.28, and 95.93 ± 16.03 min, respectively (P > 0.05). The mean onset time of sensory block in Group A was 7.29 ± 1.23, in B 4.92 ± 0.60, and in C 4.79 ± 0.91 min (P < 0.05). The mean onset time of motor block in Group A was 8.75 ± 0.55, in B 7.79 ± 0.42, and in C 7.57 ± 0.29 min. In Group A, mean time of sensory block was 194.4 ± 6.80, in B 236.60 ± 12.79, and in C 254.30 ± 7.32 min. In Group A, mean duration of motor block was 180.2 ± 5.22, in B 188.7 ± 4.04 and in C 199.6±6.69 min. In Group A, mean duration of analgesia was 215.7 ± 14.6, in B 445.8 ± 18.92, and in C 522.3 ± 16.33 min. The incidence of adverse effects was insignificant.
Conclusion: We conclude that midazolam potentiates the effect of fentanyl in terms of prolonged duration of analgesia and prolonged motor and sensory block when used as an adjuvant of bupivacaine without any significant hemodynamic compromise.

Author Biographies

Sunil Kuldeep, SMS Medical College and Hospitals, Jaipur, Rajasthan, India

Junior Resident, Department of Anaesthesia

Malkhan Singh, SMS Medical College and Hospitals, Jaipur, Rajasthan, India

Senior Resident, Department of Anaesthesia

Sunil Chauhan, SMS Medical College and Hospitals, Jaipur, Rajasthan, India

Senior Professor, Department of Anaesthesia

Siddharth Sharma, SMS Medical College and Hospitals, Jaipur, Rajasthan, India

Associate Professor, Department of Anaesthesia


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