A comparative study midazolam versus propofol for sedation during regional anaesthesia at tertiary health care centre

 

 

Abstract               Background: Conscious sedation is being widely used in various diagnostic, surgical and therapeutic procedures. Its use in spinal anesthesia is becoming increasingly popular. Aims and Objectives: To study Midazolam versus Propofol for Sedation During Regional Anaesthesia at tertiary health care centre. Methodology: This was a cross sectional study carried out in the department of anesthesiology at tertiary health care centre during the one year period i.e. January 2017 to January 2018 .Using conscious sedation using midazolam in group-I vs. propofol in group-II. In 80 patients of ASA Grade I,II,and III, were randomly divided in two groups, 40 in each group, The statistical analysis was done by Chi -square test calculated by SPSS software version 19. Result: In our study we have seen that Age distribution in both the group was comparable with each other (X2=2.412,df=5,P>0.05), Sex distribution in our study was comparable with each other (X2=0.05,df=1,p>0.05), Recovery at the end of surgery. In Group II 67.5% of patient were calm and quiet while 35% Group I. In group II, 12.5% of patients were asleep, arousable and in Group I, 22.5% of patients were asleep, arousable. Recovery and in end of surgery is highly statistically significant, in group II .( X2=8.50,df=2, P <0.01) , There was significantly less number of recall of events in Group II Preoperative and intraoperative events, than Group I (X2=11.44,df=3,p<0.0096). Conclusion: It can be concluded from our study that Propofol was better than Midazolam as compared to Sedation during regional anesthesia so propofol should be preferred over midazolam.

Key Word: midazolam.

In the regional anesthesia the type of anesthesia is given as conscious sedation Conscious sedation is the use of medication to minimally depress the level of consciousness in a patient while allowing the patient to continually and independently maintain a patent airway and respond appropriately to gentle physical stimulation or verbal communication, e.g. “open your eyes”. Conscious sedation is being widely used in various diagnostic,^1,2 surgical and therapeutic procedures. Its use in spinal anesthesia is becoming increasingly popular.³ The goals and objectives of conscious sedation are to provide a tranquil patient, free from anxiety with reduced attention, amnesia and retention of verbal communication and cooperation albeit sluggish.⁴ It provides calming effect and minimizes stress. Despite the established record⁵ of safety of conscious sedation, problems have occurred as one degree of sedation may progress to another depending upon the dose of the administered drug. These include hypoventilation, apnoea, airway obstruction and cardiopulmonary impairment. Appropriate agents provide safe and effective sedation and ensure greatest margin of safety. Conscious sedation may be produced by administration of various pharmacological agents by several common routes.^6-9 In our study we have seen the study of Midazolam versus Propofol for Sedation During Regional Anaesthesia at tertiary health care centre

 

METHODOLOGY

This was a cross sectional study carried out in the department of anesthesiology at tertiary health care centre during the one year period i.e. January 2017 to January 2018 .Using conscious sedation using midazolam in group-I vs. propofol in group-II. In 80 patients of ASA Grade I,II,and III, were randomly divided in two groups, 40 in each group,of between 15 to 60 years of either sex undergoing any surgery under regional anesthesia (spinal, epidural anesthesia or peripheral nerve blocks, Routine of emergency surgery were included into study while the patients with history of allergic reaction to the study medication, Chronic opioid or sedative drug use, Obesity(>130% for ideal body weight), Clinically significant cardiac, pulmonary, hepatic or renal dysfunction were excluded from study. The statistical analysis was done by Chi -square test calculated by SPSS software version 19.

 

RESULT

Table 1: Demographic data

      (X²=2.412,df=5,P>0.05)

Age distribution in both the group was comparable with each other (X²=2.412, df=5,P>0.05)

 

Table 2: Distribution of the patients as per the sex

(X²=0.05,df=1,p>0.05)

Sex distribution in our study was comparable with each other (X²=0.05,df=1,p>0.05).

 

Table 2: Recovery at the end of surgery

(X²=8.50, df=2, P <0.01, statistically significant) From above table recovery at the end of surgery. In Group II 67.5% of patient were calm and quiet while 35% Group I. In group II, 12.5% of patients were asleep, arousable and in Group I, 22.5% of patients were asleep, arousable. Recovery and in end of surgery is highly statistically significant, in group II. ( X²=8.50,df=2, P <0.01)

Table 3: Recall of events

 (X²=11.44, df=3, p<0.0096)

From Above table there was significantly less number of recall of events in Group II Preoperative and intraoperative events, than Group I (X²=11.44,df=3,p<0.0096)