Comparison of analgesic effect and duration of midazolam and fentanyl addition to intrathecal bupivacaine 0.05% in lower limb orthopedic surgeries

摘要

Background and Aim: Local anesthesia has gained popularity in recent years; therefore, the present study was aimed to test the effect of adding midazolam and fentanyl to intrathecal bupivacaine in patients with orthopedic surgeries of lower limbs . Materials and Methods: A double-blind, randomized clinical trial was conducted on 75 patients who underwent orthopedic surgery of their lower limbs in the 5Azar Teaching Hospital in the city of Gorgan, Iran. Patients were randomly allocated to the test groups of bupivacaine plus normal saline (BN), bupivacaine plus midazolam (BM), and bupivacaine plus fentanyl (BF). Duration of analgesia, pain intensity, chills, nausea, vomiting, systolic and diastolic blood pressure as well as pulse rate and SpO_(2) were assessed. Descriptive analysis was used to explain the mean and standard deviation. One-way ANOVA, repeated measure ANOVA, and chi-square tests were carried out using SPSS Statistics software version 19. Results: The mean age of patients was 45.29 ± 14.02, 42.16 ± 15.68, and 40.7 ± 14.72 years respectively in the groups of BF, BM, and BN. Tukey test showed a considerable difference between the BM and BF groups ( p < 0.001), and BM and BN groups ( p < 0.001) regarding the duration of analgesia. Moreover, Tukey test showed a significant difference between the BM and BN groups in minutes of 60 ( p = 0.02) and 90 ( p = 0.001), the BM and BN groups, and in final, between the BM and BF groups in minutes of 120 ( p < 0.001). Conclusion: The combination of either BM or BF may be useful to provide patients with longer duration of analgesia and also enable them to tolerate pain better.?.