لگا رہا ہوں مضامینِ نو کے پھر انبار
خبر کرو مرے خرمن کے خوشہ چینوں کو
میر انیسؔ
The Holy Prophet (PBUH) was sent to establish justice. He made use of law and good conduct to achieve this great target. Complete investigation and transport exploration is of universal value that holds fundamental significance in legal system. This research article presents insight, broadness and transparency of investigatory system established by the Prophet (PBUH). It also highlights rules and laws in the light of valid research references. All these features are evident in Prophet’s personality. In this regard, keeping in view the nature of topic, the guidance has been sought from the commands of The Quran, Hadith and different incidents of the life of Muhammad (SAWW). A discussion has been premeditated to explore Prophet’s tactics regarding law of investigation. This research article, having research outlook and logical link, touches upon the rules and principles which the Holy Prophet (PBUH) has given us for the recognition of the real culprit of good judgment, clues and witnesses. Investigative departments are radically important for the protection of Islam, maintenance of peace, internal stability and the protection of life, honor and property of people living in the society. The charter of these agencies is to abolish oppression, establish justice, impose the writ of law, and punish the guilty and to bring lawbreakers within the grip of law. The officer who performs the above duties is known as Naazir e Jaraaim1 in Islamic jurisprudential terminology. Further duties which fall within the remit of this officer are: Investigation of charges, production of the accused before a court of law, getting proven criminals sentenced by the court, executing the sentence handed down, releasing the accused in case evidence is not sufficient and getting wrongful accusers punished properly.
Background: Intrathecal adjuvants are added to local anaesthetics to improve the quality of neuraxial blockade and prolong the duration of analgesia during spinal anaesthesia. As an intrathecal adjuvant, fentanyl improves the onset and quality of spinal blockade as compared to plain bupivacaine and confers a short duration of postoperative analgesia. However, its use is associated with several adverse effects that range from pruritus to life threatening respiratory depression. Intrathecal midazolam as an adjuvant has been used and shown to improve the quality of spinal anaesthesia and prolong the duration of postoperative analgesia. No studies have been done comparing intrathecal fentanyl with bupivacaine and intrathecal 2mg midazolam with bupivacaine.
Objective: To compare the effect of intrathecal 2mg midazolam to intrathecal 20 micrograms fentanyl when added to 2.6 ml of 0.5% hyperbaric bupivacaine, on post-operative pain, in patients undergoing lower limb orthopaedic surgery under spinal anaesthesia.
Study design: Single blinded Randomized Controlled Trial
Methods: A total of 40 patients undergoing lower limb orthopaedic surgery under spinal anaesthesia were randomized to two groups
Group 1; 2.6mls 0.5% hyperbaric bupivacaine with 0.4mls (20micrograms) fentanyl
Group 2; 2.6mls of 0.5% hyperbaric bupivacaine with 0.4mls (2mg) midazolam
Results: The duration of effective analgesia was longer in the midazolam group 384.05min as compared to the fentanyl group 342.6min. There was no significant difference (‘P’ 0.4047). The time to onset was significantly longer in midazolam group 17.1min as compared to the fentanyl group 13.2min (‘P 0.023’). The visual analogue score at rescue was significantly lower in the midazolam group 5.55 as compared to the fentanyl group 6.35 (‘P - 0.043’).
Conclusion: On the basis of the results of this study, there was no significant difference in the duration of effective analgesia between adjuvant intrathecal 2mg midazolam as compared to intrathecal 20micrograms fentanyl for patients undergoing lower limb orthopaedic surgery.