Midazolam as an adjunct to lignocaine at two different doses in ultrasound-guided supraclavicular brachial plexus block : a randomized controlled trial

Abstract EN

The present study was carried out to investigate the efficacy of midazolam at two different doses as an adjunct to lignocaine with adrenaline in ultrasound-guided supraclavicular brachial plexus block.

Materials and methods In this prospective controlled study, 95 consenting patients scheduled for forearm fracture surgeries were randomized into three groups.

Five patients were excluded fromthe study for not meeting the inclusion criteria.

Group L (n = 30) received 20 ml of 1.5% lignocaine with adrenaline (1 : 200 000) + 5ml of normal saline (total volume = 25 ml).

Group M30 (n=30) received 20ml of 1.5 % lignocaine with adrenaline (1 : 200 000) + 30 μg / kg midazolam+normal saline (total volume = 25 ml).

Group M50 (n=30) received 20ml of 1.5 % lignocaine with adrenaline (1 : 200 000) +50 μg / kg midazolam + normal saline (total volume =25 ml).

Results The onset of sensory and motor block was found to be earliest in group M50, followed by group M30 and group L, and the difference was statistically significant (P<0.05).

The mean duration of motor block and sensory block was longest in groupM50 followed by groupM30 and shortest in group L, which was also statistically significant (P<0.05).

The mean duration of analgesia was longest in group M50 (254.53 ± 34.77 min) followed by group M30 (211.03 ± 52.69 min) and shortest in group L (181.47 ± 20.63 min).

The differences were statistically significant (P<0.05).

Group L received the highest doses of rescue analgesics (2.80 ± 0.407 doses) followed by group M30 (1.97 ± 0.615 doses) and group M50 (1.47 ± 0.819 doses).

The difference was statistically significant (P<0.05).

Conclusion Midazolam increases the duration of sensory and motor blockade and delays need for rescue analgesic.

In addition, midazolam at a dose of 50 μg / kg had superior therapeutic profile compared with 30 μg / kg, and hence may be the recommended dose.