Key result
Adding intrathecal fentanyl or midazolam to bupivacaine prolongs analgesia by up to ~104 minutes.
Why the study?
The effectiveness of intrathecal fentanyl and midazolam as adjuvants to spinal anaesthesia for lower abdominal gynaecological surgeries was assessed.
Do intrathecal adjuvants like fentanyl or midazolam improve the quality and duration of spinal anaesthesia in patients undergoing lower abdominal gynaecological surgeries?
Population
75 patients undergoing lower abdominal gynaecological surgeries
Comparison
3.5 mL 0.5% hyperbaric bupivacaine + 20 µg fentanyl or 2 mg midazolam vs 3.5 mL 0.5% hyperbaric bupivacaine + 0.4 mL normal saline
Design
Randomized controlled trial
Follow-up
Early post-operative period
Authors
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No significant differences between adjuvants; leaves open optimal spinal adjunct selection for gynaecological procedures.
RCT (n=75)
No
Do intrathecal adjuvants like fentanyl or midazolam improve the quality and duration of spinal anaesthesia in patients undergoing lower abdominal gynaecological surgeries?
Absolute Event Rate: 233.8% vs 129.4%
p-value: p=<0.0001
Intrathecal fentanyl or midazolam added to bupivacaine significantly prolongs the duration of analgesia and improves patient satisfaction in lower abdominal gynaecological surgeries.
Shunmugavelu et al. (2016) conducted an RCT in Lower abdominal gynaecological surgeries (n=75). Intrathecal Fentanyl or Midazolam vs. 0.4 mL normal saline added to 17.5 mg of 0.5% Bupivacaine was evaluated on Duration of analgesia (p=<0.0001). Intrathecal addition of 20 µg fentanyl or 2 mg midazolam to bupivacaine significantly prolonged the duration of analgesia compared to bupivacaine alone (233.8 and 187 mins vs 129.4 mins, p<0.0001).
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