Assessment of Efficacy of Midazolam Added with Lignocaine and Bupivacaine to Brachial Plexus Block : A Comparative Study

Abstract

Background: Regional anesthesia has much to offer for patients, surgeons and anesthesiologists because of its inherent simplicity, preservation of consciousness, avoidance of airway instrumentation, rapid recovery and significant postoperative analgesia. The supraclavicular block is one of several techniques used to accomplish anesthesia of the brachial plexus.Objectives:To evaluate analgesic efficacy, sedation, hemodynamic effects and complications, using midazolam (50ug/kg) added to brachial plexus block with lignocaine(1.2%) and bupivacaine (0.5%).Methods: It was comparative interventional study conducted at tertiary care hospital.The patients were for elective and emergency operations that came as cases of hand and forearm injuries during the period Oct-2007 to Oct-2008.Results: The latency for sensory block was minimum with group I (12.65±3.25mins) and maximum with group III (18.45±3.51mins). Similar results were shown for the motor block latency. When evaluated for the sedation score, it was found that there was statistically significant difference between the sedation in group II & III (p-value = 0.02) and I & III (p-value = 0.04) but there was no statistically significant difference between I & II (p-value = 0.59). Again, it was found that group I had minimum post-operative pain score of 40±14.87 and was maximum with group III 66.5± 10.77.Conclusion:The group with midazolam intervention were found to have minimum time for onset and maximum duration for sensory and motor block. Also, intervention group were having maximum sedation score and minimum post-operative pain score. We observed that there were no statistically significant variation in mean pulse, blood pressure throughout the observation period.