Comparative Study between Epidural Verapamil and Midazolam for Postoperative Analgesia in Lower Abdominal Surgeries

Sixty patients ASA physical status I and II were studied. They were scheduled for elective short or moderate lower abdominal surgical procedures. They were randomly divided into three groups 20 patients each: gpl received 10ml bupivacaine 0.25% diluted in normal saline, gp II, received 0.05mg/kg midazolam and bupivacaine 0.25% in a total volume of 10ml. gp III, received 5mg verapamil, and bupivacaine 0.25% in a total volume of 10ml. All patients received standardized general anesthesia and the study drug was injected at the end of surgery. Routine monitorings were applied to all patients and lasted throughout the study period for the 1^st 6 hours postoperative. Systolic, Diastolic blood pressure, HR were measured, the intensity of postoperative pain was assessed by VAS and the depth of sedation by the Observer s Assessment of Alertness/Sedation Score (OAA/S). No significant changes in the hemodynamics occurred among groups, VAS showed significant decrease in gp II (bupivacaine, midazolam) 15min after injection and lasted for shorter duration than the other 2 groups. OAA/S only changed in gp II patients. We concluded that epidural midazolam gives good postoperative analgesia with rapid onset but the accompanied sedation may limit early ambulation, on the other hand verapamil contributes to a better more prolonged postoperative analgesia devoid of sedation.