Supraclavicular brachial plexus block: Using midazolam as an adjuvant to bupivacaine: A double blind randomized trial

Gopal lal Bansal; Anupama Gupta

Volume : VI, Issue : VIII, August - 2017

Supraclavicular brachial plexus block: Using midazolam as an adjuvant to bupivacaine: A double blind randomized trial

Gopal Lal Bansal, Anupama Gupta

Abstract :

Objectives: To assess and compare onset and duration of sensory and motor block, sedation score, duration of analgesia and requirement of rescue analgesia in postoperative period.

Methods: After approval from the ethical committee a prospective randomized, double blind study of 100 patients of ASA I/ II, aged 18 to 60 years, undergoing upper limb orthopaedic surgeries under PNS guided supraclavicular achial plexus block were taken and randomly allocated into 2 groups.

Group A (n=50): Inj. Bupivacaine (0.5%) 20 ml+ Inj. Normal Saline 10 ml (Total vol.30 ml)

Group B (n=50): Inj. Bupivacaine (0.5%) 20 ml+ Inj. Midazolam (preservative free) 0.05 mg/kg in 10 ml normal saline (Total vol.30 ml).

Results: The mean onset of sensory and motor block was significantly fast (P value < 0.05) in Group BM (sensory 11.2�3.3min, motor 8.8�3.4 min) compared to Group B (sensory 16.2�4.3 min, motor13.4�4.0min). The mean duration of analgesia was significantly longer in Group BM (12.4�3.7Hrs) compared to Group A (6.4�2.2 hrs).The mean duration of motor block in Group B (5.18�2.032 Hrs) was comparable to Group BM (5.16�1.338hrs).The mean number of rescue analgesic doses required in Group BM (3.0�0.4) was significantly less than in Group B (1.88�0.6273).

Conclusion: The addition of Midazolam (0.05mg/kg) as an adjuvant to Bupivacaine has faster onset of sensory and motor block, higher sedation scores, longer duration of analgesia and less number of rescue analgesics requirement in postop-24 hours with stable haemodynamic variables.