Volume : 6, Issue : 8, August - 2017
Supraclavicular brachial plexus block: Using midazolam as an adjuvant to bupivacaine: A double blind randomized trial
Gopal Lal Bansal, Anupama Gupta
Abstract :
<p> <b style="text-align: justify;"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"">Objectives:</span></b><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: "Times New Roman", serif;"> To assess and compare </span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: "Times New Roman", serif;">onset </span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: "Times New Roman", serif;">and duration of sensory and motor block</span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: "Times New Roman", serif;">,</span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: "Times New Roman", serif;"> sedation score, duration of analgesia and requirement of rescue analgesia in postoperative period.</span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif"">Methods:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif"; mso-fareast-font-family:"Arial Unicode MS""> After approval from the ethical committee a prospective randomized, double blind study of 100 patients of <span style="color:#131313">ASA I/ II, </span>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.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><span lang="EN-IN" style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";mso-fareast-font-family: "Arial Unicode MS"">Group A (n=50): Inj. Bupivacaine (0.5%) 20 ml+ Inj. Normal Saline 10 ml (Total vol.30 ml)<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><span lang="EN-IN" style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";mso-fareast-font-family: "Arial Unicode MS"">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).<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align: justify;text-justify:inter-ideograph"><span lang="EN-IN" style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif";mso-fareast-font-family: "Arial Unicode MS""> </span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif"">Results:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif""> 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). <span style="letter-spacing:-.5pt">The mean duration of analgesia was </span>significantly longer<span style="letter-spacing:-.5pt"> in Group BM (12.4±3.7Hrs) compared to Group A (6.4±2.2 hrs</span>).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).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size:12.0pt; line-height:115%;font-family:"Times New Roman","serif"">Conclusion:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Times New Roman","serif""> 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.<o:p></o:p></span></p>
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Download PDF Journal DOI : 10.15373/2249555XCite This Article:
Gopal lal Bansal, Anupama Gupta, Supraclavicular brachial plexus block: Using midazolam as an adjuvant to bupivacaine: A double blind randomized trial, GLOBAL JOURNAL FOR RESEARCH ANALYSIS : VOLUME-6, ISSUE-8, AUGUST-2017


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