• Users Online: 432
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 94-100

Comparison of impact of adjuvant treatment of midazolam, fentanyl, and magnesium sulfate with intrathecal bupivacaine on block characteristics and postoperative analgesia in knee arthroplasty: A randomized clinical trial


1 Anesthesiology Department, Arak University of Medical Sciences, Arak, Iran
2 Department of Orthopedic Surgery, Arak University of Medical Sciences, Arak, Iran
3 Student Research Committee, Arak University of Medical Sciences, Arak, Iran

Correspondence Address:
Esmail Moshiri
Anesthesiology Department, Arak University of Medical Sciences, Arak
Iran
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2221-6189.347776

Rights and Permissions

Objective: To compare the efficacy of midazolam, fentanyl, and magnesium sulfate as adjuvants to intrathecal bupivacaine on both block characteristics and postoperative analgesia in knee arthroplasty. Methods: This randomized double-blind clinical trial recruited spinal anesthesia patients of the American Society of Anesthesiologists class I or II, who needed knee arthroplasty. Patients were stratified into three intervention groups, including the midazolam group, the fentanyl group, and the magnesium sulfate group, and the patients were administered with midazolam, fentanyl, and magnesium sulfate, respectively. Hemodynamic parameters, sensory and motor block, and pain score (Visual Analogue Scale) were measured and compared among the three groups. Results: A total of 105 patients were included in this study with 35 patients in each group. There was no statistically significant difference in terms of oxygen saturation, mean blood pressure, duration of surgery, and postoperative complications, including nausea, vomiting, bradycardia, dizziness, and hypotension, as well as the time of opioid administration among the three groups (P>0.05). Statistically significant differences were found in terms of heart rate at 15, 30, 45, 60, 75, and 105 min after beginning of operation among the three groups, which was lower in the midazolam group (P<0.05). The midazolam group showed a shorter time to achieve sensory block after spinal anesthesia, sensory block to T8 or higher and sensory block to T12 and L1 (P<0.05). Besides, the three groups showed significantly differences in terms of onset of motor block after spinal anesthesia and time to achieve motor block to T8 or higher or Bromage score 3 (P=0.001). No significant difference was noted in pain scores among the three groups (P>0.05). Conclusion: Midazolam resulted in a shorter time to achieve sensory and motor block to T8 or higher, the onset of motor block and sensory block after spinal anesthesia, and time to achieve sensory block to T12 and L1, and the pain scores were not significantly different among the groups. Thus, midazolam can be highly underlined, if a shorter onset of sensory and motor blocks is targeted. [Funded by the research deputy of Arak University of Medical Sciences (No.99258); fa.irct.ir number, IRCT20141209020258N164].


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed671    
    Printed16    
    Emailed0    
    PDF Downloaded72    
    Comments [Add]    

Recommend this journal