Related Experiment Video

Updated: Sep 25, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
03:14

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy

Published on: January 31, 2025

634

Effect of adding midazolam to intrathecal bupivacaine in children undergoing lower abdominal surgeries: A randomised

Ahmed A Shama1, Ka Ting Ng2, Moustafa M Shahen3

  • 1Department of Anaesthesia and Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt.

Indian Journal of Anaesthesia
|May 2, 2022
PubMed

Insights

Adding midazolam to intrathecal bupivacaine for pediatric spinal anesthesia speeds block onset and prolongs anesthesia and postoperative analgesia. This combination offers improved pain management for children undergoing lower abdominal surgery.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • General anesthesia avoidance is crucial for short-duration pediatric surgeries.
  • Spinal anesthesia is a suitable alternative for pediatric lower abdominal surgeries.
  • Midazolam is a safe premedication option for children.

Purpose of the Study:

  • To evaluate the impact of adding midazolam to intrathecal bupivacaine.
  • Assess effects on intraoperative quality, spinal anesthesia duration, and postoperative analgesia in children.

Main Methods:

  • Prospective, comparative interventional study of 120 pediatric patients.
  • Randomized groups: intrathecal bupivacaine plus saline (B/S) vs. bupivacaine plus midazolam (B/M).
  • Evaluated pain using Observational Pain-Discomfort Scale (OPS), motor block recovery (Bromage scale), and sedation (Wilson Sedation Score).

Main Results:

  • Faster onset of sensory and motor blocks in the bupivacaine-midazolam group (B/M).
  • Significantly longer durations of sensory and motor recovery in group B/M.
  • Reduced need for postoperative analgesia and higher sedation scores in group B/M.

Conclusions:

  • Intrathecal bupivacaine-midazolam combination significantly prolongs spinal anesthesia duration.
  • This combination provides extended postoperative analgesia for pediatric patients.
Abstract

Keywords:
Bupivacaineintrathecal injectionmidazolampaediatricpainpostoperative

More Related Videos

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy08:50

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

Published on: June 25, 2013

13.4K
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

1.8K

Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
512
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
840
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
215
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
612
General Anesthesia: Overview01:24

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
310
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
391