Comparison between intravenous dexmedetomidine and midazolam for sedation during upper extremity surgeries under supraclavicular brachial plexus block

Abstract

Background: The search for an ideal sedative agent during surgery under brachial plexus block still goes on. Midazolam is commonly used as a intraoperative sedative but it has no impact on brachial plexus block. Dexmedetomidine is a new alpha 2 receptor agonist used widely for sedation. Our aim was to compare the efficacy of  equivalent doses of dexmedetomidine infusion with midazolam  on sedation,block characteristics and patient satisfaction. Methods: In this study, 100 American Society of Anesthesiologists (ASA) I and II patients posted for forearm surgeries under ultrasound-guided brachial plexus block were divided to receive either midazolam (Group M) or dexmedetomidine (Group D) infusion. They were administered an initial loading dose of the midazolam and  dexmedetomidine over 10 min followed by a maintenance dose till the end of the surgery. Effect on sedation,block characteristics and patient satisfaction were monitored. P < 0.05 was considered statistically significant. Results: Time of onset of sedation was earlier in dexemedetomidine group compared to midazolam group. Profile of  block characteristics was better compared to midazolam group. Patient satisfaction score was greater in dexemedetomidine group compared to midazolam group.Conclusion: Dexmedetomidine may  be a better alternative to midazolam for sedation in patients undergoing surgeries in brachial plexus block.