Perbandingan Penambahan Midazolam 1 Mg dan Midazolam 2 Mg pada Bupivakain 15 Mg Hiperbarik Terhadap Lama Kerja Blokade Sensorik Anestesi Spinal

Abstract

Background and objective: Intrathecal administration of midazolam has been reported to have antinociceptive action, and to be an effective analgesic agent. In this study, we investigated the duration of sensory blockade and sedation effect of 2 doses of intrathecal midazolam as an adjunct to bupivacaine for spinal anesthesia. Methods: After getting the approval from the ethic committee, fifty patients, ASA physical state 1-2, aged 18-60 years old, undergoing elective surgery with spinal anesthesia in OR of Adam Malik General Hospital and Dr Pirngadi General Hospital Medan. The sample then divided randomly to two groups with 25 samples each group. Group I by adding 1 mg of midazolam into 15 mg 0,5 % hyperbaric bupivacaine + 0,2 ml saline whereas group II 2 mg midazolam into 15 mg 0,5 % hyperbaric bupivacaine. All patients received equal preloading with 15 ml/kg BW Lactate Ringer infusion a half an hour before spinal anesthesia. No premedication given. The duration of sensory block and sedation level were recorded. The results were analyzed statistically by using t-test, Mann-Whitney and chi square test. Result: The statistically calculation showed that the duration of sensory block was not different among the groups. The 2 segment regression in 15 mg 0,5 % hyperbaric Bupivacaine + Midazolam 1 mg group and 15 mg 0,5 % hyperbaric Bupivacaine + Midazolam 2 mg group were equal, (160 ± 31,4 min) versus (198,1 ± 22,5min) (p>0,05). Patients began complaining of mild pain or VAS 3 pain was equal in Midazolam 1 mg group (240±69,6 min) compared to Midazolam 2 mg group (256±48,7 min) (p>0.05). There were no differences in sedation scale in both groups, p> 0,05. Conclusion: The duration of sensory block and sedation scale were not different among the groups.