Aims: Comparison of intrathecal Midazolam and fentanyl with hyperbaric ropivacaine to assess duration & quality of spinal blockade.

Method: A prospective, randomized, double-blinded study conducted on 90 patients, aged 20-60 years, ASA I & II, undergoing infra-umbilical surgeries, into three groups given hyperbaric ropivacaine intrathecally along-with: 0.5 ml of normal saline (group R) 0.5 ml of 25 μg fentanyl (group RF) and 0.5 ml of 1 mg midazolam (group RM) .Onset, duration of blockade, postoperative pain, time to first rescue analgesia and side effects were noted. P-values < 0.05 considered significant.

Result: Demographic profile, surgery type, duration, vital parameters, onset & duration of sensory & motor blockade, postoperative sedation were comparable. Time to first sensation of pain was earlier in group R (150 ± 31 min) than in group RF (205 ± 30 min), group RM (195 ± 29 min). First analgesic dose time, earlier in group R (181 ± 26 min), group RF (242 ± 31 min), group RM (233 ± 26.7 min), faster time to two-segment regression in group R (122 ± 13.4 min) compared with group RF (162 ± 14.8 min), group RM (151 ± 16.4 min). Nausea-vomiting in 6 cases & pruritus in 10 cases in group RF.

Conclusion: Intrathecal midazolam with ropivacaine is better alternative than ropivacaine alone or with fentanyl for increasing block duration & decreasing postoperative analgesia need.

Keywords:  Midazolam, Ropivacaine, Fentanyl, intrathecal, infra-umbilical.

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Dr Anil Panwar

JR3 Dept of Anaesthesiology, Jhalawar Medical College, Jhalawar, India