COMPARISON EFFECT OF INTRATHECAL MIDAZOLAM ON ACUTE PAIN SCORE IN COMPARISON WITH FENTANYL IN LOWER LIMB FRACTURES (BELOW THE KNEE)

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SALIMI A.R.; SAFARI FARHAD; AZARI A.; GACHKAR L.; MOTAGHI K.

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Journal: JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE Year:2009 | Volume:31 | Issue:67 Page(s): 59-68

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Title

COMPARISON EFFECT OF INTRATHECAL MIDAZOLAM ON ACUTE PAIN SCORE IN COMPARISON WITH FENTANYL IN LOWER LIMB FRACTURES (BELOW THE KNEE)

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MIDAZOLAMQ3

INTRATHECAL INJECTIONQ3

ACUTE PAIN SCOREQ3

Abstract

Introduction: INTRATHECAL INJECTIONs are one of the available modalities for patient s pain relief. This study assessed the efficacy of analgesic property of a benzodiazepine (MIDAZOLAM; with approved analgesic effect when administered intrathecally, IT) against an opioid (fentanyl; an analgesic drug without any local anesthetic properties when used IT). Based on previous studies, MIDAZOLAM has less side effects on hemodynamics and respiratory systems in contrast with other drugs used intrathecally for pain relief. Materials and Methods: This survey has been done as a randomized clinical trial in 60 patients with lower limbs fractures (below the knee; within 24 hrs of injury) referred to hospitals of Imam Hossein and Loghmanaldoleh (acute pain). Based on the inclusion criteria, patients were divided randomly into M group (MIDAZOLAM used IT) or F group (fentanyl used IT). The intrathecal (IT) injection was done after the primary evaluations of patient’s vital signs, receiving intravenous fluids and determining the ACUTE PAIN SCORE in each group based on VAS scores. After 15 minutes of injection, the patients new pain score were assessed again as previous. All patients underwent the general anesthesia on a predetermined protocol. All the surgical procedures were done in less than 2 hours.Results: It was shown in this study that injection of MIDAZOLAM IT is significantly more effective in acute pain relief than fentanyl does as the ACUTE PAIN SCORE reduction in M group was 3.06±1.617 while in F group was 1.46±0.507 (p-value<0.001). The pain-free time (VAS<4) duration after the surgical procedure in the ward was significantly more for the MIDAZOLAM group [for MIDAZOLAM was 7:15 (CI. 95%: 6.6-7.8) and for fentanyl group was 3:30 (CI. 95%:3.3-3.7)].Conclusion: Acute pain was relieved more effectively in patients when MIDAZOLAM used IT (4mg) in comparison with fentanyl (40μg). More studies are needed to assess more analgesic properties of IT MIDAZOLAM and it s therapeutical considerations in the other types of pain (chronic, neuropathic, etc.).

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APA: Copy

SALIMI, A.R., SAFARI, FARHAD, AZARI, A., GACHKAR, L., & MOTAGHI, K.. (2009). COMPARISON EFFECT OF INTRATHECAL MIDAZOLAM ON ACUTE PAIN SCORE IN COMPARISON WITH FENTANYL IN LOWER LIMB FRACTURES (BELOW THE KNEE). JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE, 31(67), 59-68. SID. https://sid.ir/paper/63147/en

Vancouver: Copy

SALIMI A.R., SAFARI FARHAD, AZARI A., GACHKAR L., MOTAGHI K.. COMPARISON EFFECT OF INTRATHECAL MIDAZOLAM ON ACUTE PAIN SCORE IN COMPARISON WITH FENTANYL IN LOWER LIMB FRACTURES (BELOW THE KNEE). JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE[Internet]. 2009;31(67):59-68. Available from: https://sid.ir/paper/63147/en

IEEE: Copy

A.R. SALIMI, FARHAD SAFARI, A. AZARI, L. GACHKAR, and K. MOTAGHI, “COMPARISON EFFECT OF INTRATHECAL MIDAZOLAM ON ACUTE PAIN SCORE IN COMPARISON WITH FENTANYL IN LOWER LIMB FRACTURES (BELOW THE KNEE),” JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE, vol. 31, no. 67, pp. 59–68, 2009, [Online]. Available: https://sid.ir/paper/63147/en

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