Title: Evaluation of Addition of Low Dose Midazolam to a Mixture of Low Dose Ketamine and Hyperbaric Bupivacaine Given in Subarachnoid Block in Patients Undergoing Lower Limb Orthopaedic Surgery
Authors: Dr Jalpa C. Balat, Dr Sushil M. Damor (M.S., FMAS, FIAGES), Dr Arnab Sarkar
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.27
Abstract
Background: Dr Bion used Ketamine first time intrathecally in patients wounded during war time. Intrathecal ketamine produced significant analgesia with stable haemodynamics. Combination of intrathecal Ketamine and Midazolam with Bupivacaine might have the advantages of Stable haemodynamics, prolonged duration of analgesia, synergism could reduce dose requirements, increase therapeutic index and reduce toxicity.
Aims and Objectives: To evaluate addition of low dose Midazolam to a mixture of low dose Ketamine and Hyperbaric Bupivacaine in subarachnoid block in patients undergoing lower limb orthopedic surgery to study spinal blockade characteristic, duration and quality of analgesia and side effect profile in addition to post operative analgesia.
Materials and Methods: A randomized study was carried out in the Department of Anaesthesiology, Govt. Medical College and SSG Hospital, Baroda between the periods of July 2009 to Feb 2010 with 60 patients, 30 in each group of both sexes.
Results and Conclusions: Combination of Ketamine in low dose with Bupivacaine provides stable haemodynamics without any behavioural and central side effects. Addition of Midazolam in low dose to a mixture of low dose Ketamine and Bupivacaine when given intrathecally prolongs the duration of surgical anaesthesia and pain free interval without affecting the other parameters and complications of subarachnoid block.
Keywords: Ketamine, Midazolam, Heavy bupivacaine, Subarachnoid block, Intrathecal.