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Sedation with 1 mg Intravenous Midazolam in Subarachnoid Block with Bupivacaine and Fentanyl for Lower Limb Surgeries Causes Clinical Sedation without Hemodynamic Compromise: A Randomized Controlled Trial

Year: 2025
Type: article
Abstract: cardiac arrest. Thus frequently IV sedation in SAB is frequently discouraged.Hypothesis of the present study was that SAB with bupivacaine and fentanyl would correspond to a BIS < 90,level of clinical sedation and IV midazolam 1 mg in such patients may cause hemodynamic compromise.Primary objective was to compare BIS post SAB with and without IV midazolam. Secondary objective was tocompare hemodynamic parameters.Methods: 60 patients of age 20-60 years, ASA 1 or 2, undergoing lower limb surgeries were given SAB with0.5% hyperbaric bupivacaine 2 mL (10 mg) and fentanyl 0.5 mL (25mcg). Thereafter Group A (n=30) was givenSAB with 1ml IV saline and Group B (n=30) was given SAB with IV 1mg midazolam.Parameters were recorded at baseline, then every 15 minutes till 90 minutes.Results: In Group B, BIS < 90 but not < 80 was noted from 30 minutes to at least 90 minutes. In Group A, BIS <90 was noted from 45 minutes to 60 minutes and was > 90 at all other time frames. Mean BIS was significantlymore in Group A compared to Group B (90.41 +/- 4.05 v/s 86.58 +/- 3.50 respectively) (P< 0.001). Hemodynamicparameters of heart rate, non-invasive blood pressure, oxygen saturation and respiratory rate were comparablebetween both groups (p value >0.05).Conclusion: SAB does not result in adequate intra operative patient sedation. IV midazolam 1 mg causes BIS<90 from 30 minutes till at least 90 minutes without hemodynamic compromise.
DOI: 10.55487/61kr1v84
Authors: Ummul Fabeena Mangaladan, Jyotsna Punj, Ravindra Kumar Pandey, Vanlal Darlong, Bhavuk Garg
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W4412929001
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