Abstract

Spinal anesthesia is sufficient to provide adequate motor blockage and also provides effective pain relief during the initial post-operatives period. In order to maximize post-operative analgesia, a number of adjutants have been added to local spinal anesthetics. The objective of this study is to compare the beneficial and side effects of intrathecal midazolam and ketamine in patients undergoing lower limb surgery. This prospective, open label, parallel assignment, randomized, single-center trial, included eighty patients, who were admitted for lower limb surgery with American Society of Anesthesiologists (ASA) grade I and II between the ages of 20 and 60 years to our hospital were studied for 6 months. From the onsets, intra-operative and post-operative vital signs, pain assessment by visual analogue scale, intra-operative and post operative adverse effects, and post-operative analgesia supplement time were recorded. A significantly higher Visual Analogue Scale (VAS) score were seen in intrathecal ketamine group (Group I) compare to intrathecal midazolam group (Group II). The difference in mean post-operative supplemental analgesic time (Group I: 482 ± 68.22 min, Group II: 645 ± 61.28 min) between the 2 groups was very highly significant (p < 0.001). Intrathecal midazolam with bupivacaine provides very good and prolonged post-operative analgesia compare to intrathecal ketamine with bupivacaine. The incidences of side effect are less in Group II compares to Group I.

Key words: Analgesia, intrathecal analgesia, ketamine, midazolam.