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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 5, September-October 2019, Pages 1693-1699
 

Original Article

A Comparative Study of Brachial Plexus Block Using Bupivacaine with Midazolam and Bupivacaine Alone in Upper Limb Surgeries

C Geetha1, Kiran Molli2

1Associate Professor, Department of Anesthesiology, Gandhi Medical College, Secunderabad, Telangana 500003, India. 2Senior Resident, Department of Cardiac Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvanthapuram, Kerala 695011, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.29

Abstract

Introduction: Upper limb surgeries can be done under general anesthesia. However, using Brachial plexus block is a better alternative. This method provides good muscular relaxation and also maintains intraoperative hemodynamics at a stable level. Aim of the study: To study the effect of Midazolam added to brachial plexus block by supraclavicular approach. Materials and methods: This was a prospective, randomized, single blinded study. A total of 100ASA Grade I or II adult patients who underwent upper limb surgeries under supraclavicular brachial plexus block were studied. Patients were randomly allocated to two groups of 50 each. Patients in Group B received 30 mL of 0.375% Bupivacaine and Group BM received 30 mL of 0.375% Bupivacaine with preservative free Midazolam 0.05 mg/kg. The onset time and duration of sensory and motor blockade were noted. The patients were observed for 24 hours postoperatively for hemodynamic variables, sedation scores and rescue analgesic requirements. Results: Group BM showed significantly quicker onset of sensory and motor block than Group B (p < 0.05). Group BM also had significantly longer duration of sensory and motor block (p < 0.05). Group BM had significantly less requirements for rescue analgesia (p < 0.05). Both groups showed similar hemodynamics and sedation scores postoperatively. Conclusion: Midazolam (0.05 mg/kg) in combination with 30 mL of Bupivacaine (0.375%) hastened onset of sensory and motor block, and improved postoperative analgesia when used in brachial plexus block, without producing any adverse events.


Keywords : Brachial plexus block; Bupivacaine; Midazolam; Anesthesia in upper limb surgeries
Corresponding Author : Kiran Molli