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>&nbsp;<b style="text-align: justify;"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Objectives:</span></b><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;"> To assess and compare </span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;">onset </span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, 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: &quot;Times New Roman&quot;, serif;">,</span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, 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;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Methods:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Arial Unicode MS&quot;"> 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:&#10;justify;text-justify:inter-ideograph"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Arial Unicode MS&quot;">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:&#10;justify;text-justify:inter-ideograph"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Arial Unicode MS&quot;">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:&#10;justify;text-justify:inter-ideograph"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&#10;&quot;Arial Unicode MS&quot;">&nbsp;</span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Results:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> The mean onset of sensory and motor block was significantly fast (P value &lt; 0.05) in Group BM (sensory 11.2&plusmn;3.3min, motor 8.8&plusmn;3.4 min) compared to Group B (sensory 16.2&plusmn;4.3 min, motor13.4&plusmn;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&plusmn;3.7Hrs) compared to Group A (6.4&plusmn;2.2 hrs</span>).The mean duration of motor block in Group B (5.18&plusmn;2.032 Hrs) was comparable to Group BM (5.16&plusmn;1.338hrs).The mean number of rescue analgesic doses required in Group BM (3.0&plusmn;0.4) was significantly less than in Group B (1.88&plusmn;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;&#10;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;">Conclusion:</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;"> 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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Cite 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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