A clinical comparison between bupivacaine midazolam combination and bupivacaine plain in brachial plexus block by supraclavicular approach

Background: The study is to describe the efficacy of Midazolam when used with Bupivacaine as local anesthetic in Supraclavicular brachial plexus block. The focus will be on the onset and analgesic duration of nerve blocks along with any neurotoxic concerns or neuroprotective potential. Materials and methods: A prospective, randomised single blinded study was undertaken in 100 patients posted for upper limb surgeries under supraclavicular brachial plexus block and were assigned into 2 groups, each containing 50 patients. • Control group – Group B: received 30ml Bupivacaine 0.375% • Study group – Group BM: received 30ml of mixture of Bupivacaine 0.375% and Midazolam 0.05mg/kg. Results: The onset of sensory and motor block was significantly faster in group BM compare to Group B (p<0.05). Rescue analgesic requirements were significantly less in group BM compared to group B (P<0.05). Hemodynamics and sedation scores did not differ between groups in the postoperative period. Conclusion: Midazolam 0.05mg/kg when addded to 30ml of Bupivacaine 0.375% for supraclavicular brachial plexus block speeds the onset of sensory and motor blocks (P<0.05). The combination produces improved analgesia, resulting in a prolonged effect and reduced requirements for rescue analgesics.