• Aliya Ahmed, Fauzia Anis Khan, and Aziza Hussain.
• Department of Anaesthesia, Aga Khan University Hospital, Karachi.
• J Pak Med Assoc. 2007 Nov 1;57(11):548-52.

ObjectiveIntraoperative comfort and patient satisfaction during surgical procedures under regional anaesthesia can be improved with the use of supplemental intravenous sedation. The authors conducted a study to compare two sedation techniques for surgical procedures performed under regional anaesthesia, i.e., midazolam and pethidine combination compared with midazolam and tramadol combination.MethodsForty adult American Society of Anaesthesiologists (ASA) grade 1-111 patients, aged between 40-65 years undergoing surgery under regional anaesthesia (sub-arachnoid block) were included. The patients were randomly divided into two groups. All patients received standardized premedication, intraoperative monitoring and oxygen therapy. Group A patients received midazolam 0.03 mg/kg followed by pethidine 20 mg intravenously, and group B patients received midazolam 0.03 mg/kg followed by tramadol 20 mg intravenously after the institution of regional anaesthesia. Monitoring included ECG, blood pressure, respiratory rate, oxygen saturation and sedation score. Complications, if any, were recorded. Monitoring was continued during the recovery room stay. All patients were interviewed in the evening and time of ambulation and rating of OR experience was noted.ResultsData analysis showed no significant difference between pethidine and tramadol for all the haemodynamic variables (p = > 0.05). There was also no significant difference in patient's and surgeon's assessment of their experience. Complications and recovery characteristics also did not show any significant difference.ConclusionMidazolam-tramadol combination may be used as an alternative to midazolam-pethidine combination for sedation during surgical procedures performed under regional anaesthesia.

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