Midazolam as Adjuvant: Comparison between Bupivacaine and Ropivacaine in Potentiation of Anaesthetic Effect in Supraclavicular Block: Hospital-Based Prospective Comparative Clinical Study
- 1. Senior Resident, Department of Anaesthesiology, Silchar Medical College & Hospital, Address - Ghungoor, Assam, India
- 2. Assistant Professor, Department of Orthopaedic, DMCH, Karbi Anglong, Assam, India
Description
Background: As recent trend in upper limb surgery is toward outpatient care, brachial plexus blocks have become very popular in effectively providing perioperative anaesthetic and analgesic requirement. Different agent has been added to local anaesthetic for a quicker and excellent intraoperative as well as postoperative analgesia and at the same time reducing the volume of total local anaesthetic used. As an adjuvant, midazolam is known to cause anti nociception and extend the effects of local anaesthetics with some inherent local anaesthetic properties. Purpose of the study was to assess the effect of midazolam as adjuvant, in potentiation of local anaesthetic effects in supraclavicular brachial plexus block. A hospital-based prospective comparative study was conducted after obtaining ethical committee clearance. 30 patients were included in each group using purposive sampling. Group A: Received ropivacaine with preservative free midazolam. Group B: Received bupivacaine with preservative free midazolam. The following parameters were noted: Onset of sensory block, onset of motor block, duration of sensory block, duration of motor block, duration of analgesia, haemodynamic variables, sedation score and complications were assessed. Result: The onset of sensory and motor blockade was significantly faster in group B compared to group A. Again, the duration of sensory and motor blockade was significantly longer in group B compared to group A. The duration of analgesia was also significantly longer in group B compared to group A. Haemodynamic and sedition scores did not differ between the groups in the intra and post-operative period. Complications were almost negligible in both the groups and not significant. Conclusion: In supraclavicular block with midazolam as adjuvant, bupivacaine has an advantage over ropivacaine in terms of early onset of sensory and motor blockade and helps in prolonging the duration of blockade as well as duration of analgesia.
Abstract (English)
Background: As recent trend in upper limb surgery is toward outpatient care, brachial plexus blocks have become very popular in effectively providing perioperative anaesthetic and analgesic requirement. Different agent has been added to local anaesthetic for a quicker and excellent intraoperative as well as postoperative analgesia and at the same time reducing the volume of total local anaesthetic used. As an adjuvant, midazolam is known to cause anti nociception and extend the effects of local anaesthetics with some inherent local anaesthetic properties. Purpose of the study was to assess the effect of midazolam as adjuvant, in potentiation of local anaesthetic effects in supraclavicular brachial plexus block. A hospital-based prospective comparative study was conducted after obtaining ethical committee clearance. 30 patients were included in each group using purposive sampling. Group A: Received ropivacaine with preservative free midazolam. Group B: Received bupivacaine with preservative free midazolam. The following parameters were noted: Onset of sensory block, onset of motor block, duration of sensory block, duration of motor block, duration of analgesia, haemodynamic variables, sedation score and complications were assessed. Result: The onset of sensory and motor blockade was significantly faster in group B compared to group A. Again, the duration of sensory and motor blockade was significantly longer in group B compared to group A. The duration of analgesia was also significantly longer in group B compared to group A. Haemodynamic and sedition scores did not differ between the groups in the intra and post-operative period. Complications were almost negligible in both the groups and not significant. Conclusion: In supraclavicular block with midazolam as adjuvant, bupivacaine has an advantage over ropivacaine in terms of early onset of sensory and motor blockade and helps in prolonging the duration of blockade as well as duration of analgesia.
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Additional details
Dates
- Accepted
-
2024-02-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue3,Article190.pdf
- Development Status
- Active
References
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