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ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 58-66

Effects of intrathecal midazolam in potentiating the analgesic effect of intrathecal dexmedetomidine in elderly patient undergoing hip repair surgeries


Department of Anesthesia and Intensive Care, Minia University Hospital, Minia, Egypt

Correspondence Address:
Haidy S Mansour
Department of Anesthesia and Intensive Care, Minia University Hospital, Minia, 61691
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_33_17

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Objective This study was designed to assess the effect of intrathecal midazolam on dexmedetomidine with a low-dose bupivacaine in elderly patients undergoing hip repair surgery. Materials and methods This is a double-blind study involving 75 patients with American Society of Anesthesiologists physical status II and III aged over 60 years scheduled for elective hip repair surgery under intrathecal anesthesia. They were randomly divided into three groups: control (C group) received 7.5 mg of 0.5% hyperbaric bupivacaine, dexmedetomidine group (D group) received 7.5 mg of 0.5% hyperbaric bupivacaine+5 μg of dexmedetomidine, and dexmedetomidine+midazolam group (DM) received 7.5 mg of 0.5% hyperbaric bupivacaine+5 μg of dexmedetomidine+1 mg of midazolam. The onset and duration of sensory and motor blockade, intraoperative hemodynamic change, and postoperative analgesia were recorded. Results Compared with group C, the groups D and DM had significantly faster onset of sensory block (P=0.032 and 0.0001, respectively), faster onset of motor block (P=0.024 and 0.006, respectively), prolonged duration of sensory block (P=0.003 and 0.0001, respectively), prolonged duration of motor block (P=0.015 and 0.002, respectively), prolonged duration of postoperative analgesia (P=0.0001), and significantly decreased postoperative visual analog scale sedation score for 12 h. Compared with group D, group DM had a significantly longer duration of sensory block (P=0.012), longer duration of postoperative analgesia (P=0.042), and postoperative visual analog scale significantly decreased for 12 h postoperatively. Conclusion Intrathecal addition of 1 mg midazolam to 5 µg dexmedetomidine and 7.5 mg 0.5% hyperbaric bupivacaine provided intraoperative hemodynamic stability, prolonged motor, and sensory block as well as potentiating the postoperative analgesic.


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