scholarly journals Đánh giá một số yếu tố tương quan ảnh hưởng đến gây tê đám rối thần kinh cánh tay trong phẫu thuật chi trên

2020 ◽  
Author(s):  
Văn Trí Nguyễn
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Strong Positive Correlation ◽  
Procedure Time ◽  
Group I ◽  
Group Ii ◽  
Plexus Block

EVALUATION OF SOME CORRELATIVE FACTORS AFFECTING TO BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERIES Objective: To assess correlations between age and onset sensory block, age and duration of sensory block, the procedure time and BMI. As well as evaluating the degree of sensory and motor blockade. Subjects and methods: 120 patients underwent upper limb surgery in Hue Central Hospital from 5/2017 to 6/2018. Patients were divided into two groups, group I was 60 patients undergoing ultrasound-guided supraclavicular brachial plexus block, group II was 60 patients with nerve stimulor technique. Each group received 25ml levobupivacaine 0.5% and 1 / 200,000 adrenalin. Results: There were the strong positive correlation between the procedure time and BMI, age and duration of sensory block. There was an inverse correlation between age and onset sensory block. The procedure time was 9,82 ± 4,55 minutes in group I and 14,73 ± 4,73 minutes in group II (p < 0,05). The onset of sensory and motor block was 6,15 ± 1,60 minutes and 7,95 ± 1,05 minutes in group I and 9,92 ± 2,88 minutes and 12,63 ± 2,15 minutes respectively in group II (p < 0,05). The duration of sensory and motor block was 481,38± 116,66 minutes and 412,97 ± 107,32 minutes for group I and 319,22 ± 143,14 minutes and 205,88 ± 48,96 minutes respectively in group II. Conclusion: The procedure time and BMI, age and duration of sensory block, age and onset sensory block, all of them were strongly correlated. Ultrasound guidance for supraclavicular brachial plexus blockade provides a block that was faster in onset, longer duration of block. Key words: brachial plexus block, upper limb surgeries

scholarly journals Effect of dexamethasone as an adjuvant with bupivacaine in ultrasound guided single shot supraclavicular brachial plexus block in upper extremity surgeries- a prospective randomized study

2017 ◽  
Vol 5 (5) ◽  
pp. 2139 ◽  
Author(s):  
Shaheena Parveen ◽  
Masrat Jan ◽  
Arshi Taj ◽  
Arif A. Bhat
Keyword(s):  
Side Effects ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Background: Supraclavicular brachial plexus block is a good alternative to general anesthesia in surgeries of elbow, forearm, wrist and hand. The aim of this study was to assess the effect of dexamethasone as an adjuvant with bupivacaine in supraclavicular brachial plexus block in upper limb surgeries.Methods: This study was carried out on 60 adult patients of both sexes planned for upper limb surgery during the period from May 2015 to Jan 2016 after approval by the institutional Ethical Committee. Inclusion criteria were American Society of Anesthesiologists physical Status I-II and age between 18 and 50 years. Patients were randomly allocated to two groups of 30 patients each [group I (bupivacaine alone) and group II (bupivacaine + dexamethasone)]. Group I received 30ml of 0.5% bupivacaine with 2ml normal saline while group II received 30ml of 0.5% bupivacaine with 2ml (8mg) dexamethasone for supraclavicular brachial plexus block. Statistical analysis was performed with SPSS for Windows (SPSS Inc., Chicago, IL, USA), version 16.0. For analysis of demographic data and comparison of groups, χ2, unpaired Student's t-test and Mann-Whitney U-test were performed. Power of significance p-value of <0.05 was considered to be statistically significant. We evaluated onset, quality and duration of sensory and motor block along with side effects if any.Results: The mean onset of sensory and motor block in Group I and II was statistically insignificant. The duration of motor and sensory block was significantly prolonged in Group II than in Group I. There were no statistically and clinically significant differences in respiratory and hemodynamic parameters.Conclusions: We conclude that dexamethasone as an adjuvant in supraclavicular brachial plexus block prolongs the duration of motor and sensory block with insignificant side effects.

SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK IN UPPER LIMB SURGERIES: ULTRASOUND-GUIDED VERSUS NERVE STIMULATORTECHNIQUE

2017 ◽  
pp. 104-108
Author(s):  
Van Tri Nguyen ◽  
Van Minh Nguyen
Keyword(s):  
Brachial Plexus ◽  
Success Rate ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Ultrasound Guided ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Objective: To compare the onset and duration ofsensory and motor blockade,success and complications rate of these two techniques. Subjects and methods: One hundred and twenty patients undergoing upper limb surgeries at Hue Central Hospital from May 2016 to May 2017 were divided into two groups. Group I underwentultrasound-guided supraclavicular brachial plexus block, group II with nerve stimulator. Each group received 25ml levobupivacaine 0.5% and 1/200000 adrenalin. Results:The procedure time (9.82 ± 4.55 vs 14.73 ± 4.73 min), the onset of sensory (6.15 ± 1.60 vs 9.92 ± 2.88 min) and motor block (7.95 ± 1.05 vs 12.63 ± 2.15 min) in group I were significant shorter than in Group II (p < 0.05). The duration of sensory and motor block, (481.38 ± 116.66 vs 319.22 ± 143.14 min and 412.97 ± 107.32 vs 205.88 ± 48.96 min, respectively) were significant longer in group I than in Group II (p < 0.05). The success rate (98.3% vs 90%) and complication incidence (1.7% vs 8.4%) were comparable between two groups. Conclusion: Ultrasound guidance for supraclavicular brachial plexus blockade provided faster onset, longer duration of sensory and motor block, higher success rate with fewer complications in comparison withnerve stimulator technique Key words: brachial plexus block, ultrasound-guided

A CLINICAL COMPARISON BETWEEN 0.5% BUPIVACAINE AND 0.5% BUPIVACAINE DEXAMETHASONE 8mg COMBINATION IN BRACHIAL PLEXUS BLOCK BY SUPRACLAVICULAR APPROACH

2021 ◽  
pp. 18-20
Author(s):  
Bonthu Mounica ◽  
Palle Krishna Padma Sri ◽  
K. Madhusudhan Reddy
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Single Shot ◽  
Motor Blockade ◽  
Duration Of Action ◽  
Group I ◽  
Prolonged Duration ◽  
Group Ii ◽  
Plexus Block

Aim:To study the onset and duration of sensory and motor blockade Introduction: Brachial plexus block provides a useful alternative to general anaesthesia for upper limb surgeries. Bupivacaine is one of the most frequently used local anaesthetic which has a longer duration of action of 3 to 8 hours but has drawbacks of delayed onset and patchy analgesia. Dexamethasone is a very potent glucocorticoid with very good anti-inammatory and analgesic activity. Materials and methods: A prospective, randomised single-blinded study was undertaken in patients posted for upper limb surgeries under the supraclavicular block. 60 patients with ASA class I and II were randomly grouped into two groups. Group I received 30ml bupivacaine 0.5% and Group II received a combination of 28ml bupivacaine 0.5% and 2ml dexamethasone 8mg. 30ml solution is used for a single shot blockade of supraclavicular brachial plexus. Results: Group II patients had a faster onset of action and prolonged duration of action. Discussion: The addition of dexamethasone 8mg to bupivacaine 0.5% speeds the onset of sensory and motor blockade also prolongs the duration thus provides better analgesia and reduces the requirements of rescue analgesics. Conclusion:Acombination of bupivacaine 0.5% and dexamethasone 8mg has a signicantly faster onset and prolonged duration of action.

scholarly journals A CLINICAL COMPARISON OF 0.75% ISOBARIC ROPIVACAINE WITH 0.5% ISOBARIC BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERIES

2020 ◽  
pp. 43-46
Author(s):  
Kalyan Sarma ◽  
Bandana Mahanta ◽  
Prabir Pranjal Das
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Supraclavicular Brachial Plexus Block ◽  
The Mean ◽  
Group B ◽  
Plexus Block

Background: Regional anaesthesia and analgesia, has the potential to provide excellent operating conditions along with better and prolonged post-operative with pain relief with fewer side effects. As a result, it is becoming increasingly popular for ambulatory anaesthesia and for day care patients.. Among the commonly used local anaesthetics, lignocaine and bupivacaine, bupivacaine has significant cardiovascular and central nervous system toxicity. In addition, bupivacaine also has lesser differentiation between sensory and motor blockade post-operatively. Ropivacaine and levobupivacaine were developed to avoid the bupivacaine related toxicities. The clinical safety profile of ropivacaine seems to be more favourable than that of levobupivacaine. With this background the following study was conducted to evaluate the efficacy of ropivacaine 0.75% for brachial plexus block in upper limb surgeries and its clinical comparison with bupivacaine 0.5%. Aims and Objectives: To assess the efficacy and toxicity of ropivacaine 0.75% and bupivacaine 0.5% as potential agents for brachial plexus block for surgeries of the upper limb around and below the elbow. Settings and Design: prospective, comparative, randomized, single blinded clinical trial. Materials and Methods: After institutional ethical committee approval, 100 patients physical status ASA I & II, of either sex, between 18-60 years, weighing between 40-60 kgs posted for upper limb surgeries around the elbow, forearm and hand were divide into two groups of 50 patients each. Group R (Ropivacaine group) received 0.75% isobaric ropivacaine 30 ml in supraclavicular brachial plexus block. Group B (Bupivacaine group) received 0.5% isobaric bupivacaine 30 ml in supraclavicular brachial plexus block by using peripheral nerve stimulator. Vitals, sensory, motor and analgesia score at pre-defined intervals intra-operatively were noted. Onset of analgesia, sensory & motor blockade, total duration of post-operative pain relief (VAS ≥ 5) and time of demand of first rescue analgesic were also noted along with any intra-operative complications, if any. Statistical Analysis: All the results were expressed as Mean ± SD. Statistical analysis was performed using Unpaired Student’s t-Test. Statistical significance was considered with a p value of ≤ 0.05. Results: Demographic profile and duration of surgery were comparable among the two groups. The mean time of onset of sensory block, onset of motor block and onset of analgesia were significant (p<0.05) in group R as compared to group B. The mean duration of sensory block and duration of post-operative analgesia were comparable between the two groups. However, the mean duration of motor block was significantly lower (p<0.05) in group R as compared to group B. the baseline hemodynamic variables and requirement of first analgesic dose and other adverse events were equivalent in both the group. Conclusion: Ropivacaine when compared with Bupivacaine, has faster onset of analgesia, sensory & motor blockade, significantly lesser duration of motor blockade. Ropivacaine also provides satisfactory post-operative analgesia with a stable hemodynamic profile similar to Bupivacaine with no undue adverse effects.

scholarly journals Dexmedetomidine and Clonidine as an Adjuvant to Bupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Yuvaraj Shastri ◽  
Nanjappa Nagaraju ◽  
MS Priyanka
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Randomised Clinical Trial ◽  
Ultrasound Guided ◽  
Sensory Blockade ◽  
Group I ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Introduction: Alpha‑2 agonists are used as adjuvants with Local Anaesthetic (LA) agents to prolong the duration of regional nerve blocks. Aim: To compare clonidine and dexmedetomidine as an adjuvant to bupivacaine in supraclavicular brachial plexus block with respect to onset and duration of sensory and motor block and duration of analgesia. Materials and Methods: In this randomised clinical trial, 70 American Society of Anesthesiologists (ASA) class I and class II patients, scheduled for elective upper limb surgeries under ultrasound guided supraclavicular brachial plexus block, were divided into two equal groups. Group‑I received clonidine 1 μg/ kg and group‑II received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (20 mL). Onset and recovery time of sensory and motor block, duration of analgesia were studied in both the groups. Data analysis was done using Analysis of variance (ANOVA) and Student t‑test for analysis of continuous data and Chi‑square test used to know the difference of significance in categorical data. Results: A total of 70 subjects between age group of 18‑60 years were included in the study. The onset of sensory blockade was faster in group‑I (3.54±0.74 min) than group‑II (3.86±0.88 min) but statistically not significant. The onset of motor blockade was faster in group‑I (5.4±1.12 min) than group‑II (6.34±1.14 min) and difference was statistically significant. Duration of sensory blockade was longer in group‑I (616.23±62.05 min) than group‑II (574.71±61.14 min) and motor blockade in group‑I (635.86±57.82 min) was longer than group‑II (562.80±66.89 min) and the differences were statistically significant. The duration of analgesia was longer in group‑I (797.29±108.06 min) than group‑II (695.00±91.14 min) and the difference was statistically significant. Conclusion: Dexmedetomidine shortens the onset, prolongs the duration of sensory and motor block and also provides longer postoperative analgesia as compared with clonidine when used as an adjuvant to bupivacaine in ultrasound guided supraclavicular brachial plexus block.

scholarly journals A prospective randomized clinical study to compare the efficacy of 0.25% bupivacaine with clonidine and 0.25% levobupivacaine with clonidine in supraclavicular brachial plexus block for upper limb surgeries

2021 ◽  
Vol 8 (4) ◽  
pp. 543-550
Author(s):  
Abhishek R ◽  
Arun Aravind ◽  
Shankaranarayana P
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Racemic Mixture ◽  
Hemodynamic Parameters ◽  
Randomized Clinical Study ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

:Bupivacaine is an amide local anesthetic, available as a racemic mixture of Dextro and Levorotatory Isomers. Due to its rapid onset and longer duration of anesthesia, It is routinely preferred in various regional anesthetic techniques. However, it is associated with serious cardiovascular and neurological toxicity. Its pure S- enantiomer, Levobupivacaine having similar pharmacological profile is known to have lesser cardiovascular and CNS toxicity. Combining adjuvants like clonidine, a centrally acting partial alpha-2-adrenergic agonist to improve quality of anesthesia is common practice. Hence, the aim of our study is to compare efficacy and safety of 0.25% Levobupivacaine and 0.25% Bupivacaine when combined with clonidine in supraclavicular brachial plexus block for upper limb surgeries.Eighty patients aged between 18 to 60 years with ASA physical status I-II, scheduled for elective upper limb surgeries under were randomized into two groups. Peripheral nerve stimulator guided Supraclavicular brachial plexus block was administered. Group BC received 30ml of 0.25% Bupivacaine plus 1µg/kg Clonidine and Group LC 30ml of 0.25% Levobupivacaine plus 1µg/kg Clonidine. The time of onset of sensory and motor block, duration of sensory and motor block, perioperative hemodynamic parameters, postoperative pain for 24hours and adverse effects were studies.Group LC had faster onset of sensory block (p= 0.014) as well as faster onset of motor block (p= 0.012) compared to group BC. However, durations of sensory block and motor block were statistically not significant in both the groups (p&#62;0.05). Perioperative hemodynamic parameters and assessment of pain during 24 hours of post operative period were comparable and statistically not significant.1mcg/kg of clonidine used as an adjuvant to 30ml of 0.25% Levobupivacaine produces faster onset of sensory and motor block compared to 0.25% Bupivacaine in supraclavicular brachial plexus block. However, similar anesthetic efficacy in terms of duration of sensory and motor block, hemodynamics and postoperative analgesia were observed.

scholarly journals Comparative Study between the Effect of Perineural versus Intravascular Dexmedetomidine in Ultrasound-Guided Supraclavicular Brachial Plexus Block

2020 ◽  
pp. 37-45
Author(s):  
Mahmoud A. Al Mohasseb ◽  
Wael E. Messbah ◽  
Sabry M. Amin ◽  
Nadia H. Fattooh
Keyword(s):  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Group Iii ◽  
Group I ◽  
Upper Limb Surgery ◽  
Supraclavicular Brachial Plexus Block ◽  
Group Ii ◽  
Plexus Block

Background: Augmentation of postoperative analgesia with various adjuvants has become a standard in regional anesthesia. There are no studies about dexmedetomidine multiple approaches in supraclavicular brachial plexus block (BPB) was contrasted. We compare perineural dexmedetomidine and intravenous dexmedetomidine Bupivacaine as adjuvant in supraclavicular brachial plexus block. Materials and Methods: This prospective randomized controlled double-blind study was conducted on 120 patients with age between 20 and 60 years, both sexes, scheduled for elective upper limb surgery. Patients were randomly allocated into 3 groups, 40 patients in each received plain bupivacaine 0.5% (20 ml) in supraclavicular BPB; group I (Control group): add 1 mL normal saline perineural, group II: Bupivacaine with perineural dexmedetomidine (BDP) add 1 μg.kg-1dexmedetomidine perineurally. group III: Bupivacaine with intravenous dexmedetomidine (BDV) add 0.5 μg.kg-1 dexmedetomidine in 50 mL of normal saline administered as infusion over 10 min. Onset and duration of sensory and motor blocks, hemodynamic variables, adverse effects, and duration of analgesia were assessed. Results: Heart rate and mean arterial pressure was significantly decrease in group III &group II compared to group I were compared by ANOVA (F) test. onset of sensory &motor block was statistically significant shorter in group II compared to group I & III. Duration of sensory &motor block was statistically significant longer in group II compared to group I & III. there was statistically significant decrease VAS in group II were analysed using Kruskal-Wallis test between three groups. There was statistically significant increase RSS in group II & III. The first time of analgesic request was statistically significant prolonged in duration in group II. Conclusion: Perineural dexmedetomidine (1 µg/ kg) as an adjuvant to bupivacaine is significantly high thanIV dexmedetomidine (0.5 µg/ kg) and bupivacaine alone in supraclavicular BPB as regards to the onset and the duration of sensory block, so Increasingpostoperative analgesia.

scholarly journals A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohammed Ibrahim Khamis ◽  
Ahmed Saeed Mohamed ◽  
Hesham Mohamed El Azazy ◽  
Hala Salah El Ozairy ◽  
Mohamed Moien Mohamed
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Normal Saline ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Motor Blockade ◽  
Group A ◽  
Group B ◽  
Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

scholarly journals A comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries

2018 ◽  
Vol 6 (7) ◽  
pp. 2407
Author(s):  
Fahad Khan ◽  
V. P. Singh
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Elective Surgery ◽  
Study Drug ◽  
Sensory Block ◽  
Ultrasound Guided ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

Background: Comparative study of intravenous versus perineural administration of dexmedetomidine in supraclavicular brachial plexus block using 0.75% ropivacaine by ultrasound guided technique in upper limb surgeries.Methods: Patients in the age group 18-58 years both male and female, having ASA 1 and ASA 2, scheduled for elective surgery of unilateral upper limb surgeries were included and randomly divided into three groups’ i.e. group RD, group RDI and group R and patients with chronic pain or taking any analgesics, ASA grade III and IV, bleeding disorders, history of brachial plexus injury, known allergy to the study drug, previous shoulder surgery, any psychiatric disorders, peripheral neuropathy, failed block, significant respiratory disease, hearing impairment, pregnant women, study were excluded.Results: Time to sensory onset in group RD was as compared to group RDI and group R was found statistically significant (p<0.001). Duration of sensory block (analgesia) in group RD, group RDI and Group R was also statistically significant (p<0.001). The level of sedation of Group RDI and Group RD had highly significant value till 30 mins (p<0.001).Conclusions: The central effects of dexmedetomidine also play some role in prolongation of sensory and motor block duration, as explained previously.

scholarly journals A Comparative Clinical Evaluation of Efficacy of Midazolam as an Adjuvant to Bupivacaine in Brachial Plexus Block by Supraclavicular Approach for Upper Limb Surgery

2018 ◽  
Vol 14 (2) ◽  
pp. 26-29
Author(s):  
Y Dhakal ◽  
R Rajbhandari ◽  
T N Agarwal
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Sensory Block ◽  
Hemodynamic Variables ◽  
Pain Scores ◽  
Post Operative Period ◽  
Lower Pain ◽  
Group B ◽  
Plexus Block

Introduction: Brachial plexus block is useful as a sole regional anesthetic technique for upper limb surgeries. Adjuvants to local anesthesia may enhance quality and duration of analgesia. Our study aimed to evaluate efficacy and safety of midazolam added to brachial plexus block. Methods: 394.50 ±46.874 243 ± 57.545 Addition of midazolam to bupivacaine for brachial plexus block prolongs the duration of analgesia with lower pain scores during post-operative period.  A prospective, randomized, double blind study was conducted on 60 ASA I or II adult patients undergoing upper limb surgeries under single-shot supraclavicular brachial plexus block. Patients were randomly divided into two  groups. Patients in Group B (n = 30) were administered 30 mL of 0.5% bupivacaine and Group BM (n = 30) were given 30 mL of 0.5% bupivacaine with midazolam 2mg. Hemodynamic variables (i.e., heart rate, noninvasive blood pressure), pain scores, onset of motor and sensory block, duration of analgesia and sedation score and were recorded intraoperatively and postoperatively.Results: The duration of analgesia was significantly prolonged (P<0.05) in midazolam group (394.50 ±46.874 ) compared to control group (243 ±57.545). Similarly, pain scores were significantly lower in group BM than in group B (P<0.05). The onset of motor and sensory block, sedation score and hemodynamic variables were comparable between groups. No adverse events were observed during study.Conclusion: Addition of midazolam to bupivacaine for brachial plexus block prolongs the duration of analgesia with lower pain scores during post-operative period. JNGMC, Vol. 14 No. 2 December 2016, Page: 26-29

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