Midazolam as an Adjuvant to Bupivacaine in Quadratus Lumborum Block after Caesarean Section: Does It Improve Postoperative Pain Control? A Randomized Double-Blind Clinical Trial | ||||
| Journal of Current Medical Research and Practice | ||||
| Article 12, Volume 10, Issue 2, April 2025, Page 109-116 PDF (229.73 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jcmrp.2024.305265.1091 | ||||
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| Authors | ||||
Ahmed Ismail Abdel Sabour   1; Mohamed Youssef2; Emad Zarief Kamel2; Mostafa El Sonabaty3; Elia Nagib2; Mansour Algazar4; Wesam Ali Neshat2
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| 1Anesthesia, Intensive Care & Pain Management, Faculty of Medicine, New Valley University, Egypt. | ||||
| 2Anesthesia, Intensive Care & Pain Management, Faculty of Medicine, Assiut University, Assiut, Egypt. | ||||
| 3Gynecological and Obstetric, Faculty of Medicine, Assiut University, Assiut, Egypt. | ||||
| 4House officer of AL-Azhar University, Faculty of Medicine, Assiut University, Assiut, Egypt. | ||||
| Abstract | ||||
| Background: The Quadratus Lumborum Block (QLB) effectively provides postoperative analgesia. In this study, we sought to demonstrate the impact of adding Midazolam to the Quadratus Lumborum Block on the 24-hour total dosage of ketorolac, 1st VAS in the first 24 hours, initial analgesia required, and duration of analgesia after cesarean section [1, 2]. Methods: Forty-two female patients who underwent cesarean sections were included in this research. The study group got 41 ml (40 ml bupivacaine 0.25% with 5 mg midazolam in 1 ml) divided on each side. We assessed the amount of ketorolac consumed over 24 hours, the VAS score, and the time for the first analgesia request (for ketorolac). Results: Forty-two participants participated in this double-blinded, prospective, controlled randomized clinical study. Compared to the control group, the study group's VAS decreased significantly at rest and during movement (2,4,8, and 12 hours) with a p-value < 0.0001. Compared to the control group (10.43 ± 1.75) hours, the study group had a substantial delay in their initial analgesic demand (15.48 ± 1.75) hours. The ketorolac dosages were significantly lower in the midazolam group (35.45 ± 11.8 mg) compared to the control group (55.7 ± 10.7mg). Discussion: Posterior QLB reduces postoperative pain following cesarean surgery. Midazolam reduces ketorolac dosages, the VAS score, and the initial rescue analgesia when added to PQLB. | ||||
| Keywords | ||||
| VAS; ketorolac; Quadratus Lumborum Block (QLB) | ||||
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