Canadian Journal of Anesthesia

, Volume 52, Issue 8, pp 822–826 | Cite as

Brachial plexus block with midazolam and bupivacaine improves analgesia

  • Koj Jarbo
  • Yatindra Kumar BatraEmail author
  • Mnams Nidhi
  • Bidyut Panda



Adjuncts to local anesthetics for brachial plexus block may enhance the quality and duration of analgesia. Midazolam, a water-soluble benzodiazepine, is known to produce antinociception and enhance the effect of local anesthetics when given epidurally or intrathecally. The purpose of this study was to assess the effect of midazolam added to brachial plexus anesthesia.


A prospective, randomized, double blind study was conducted on 40 ASA I or II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly divided into two groups. Patients in Group B (n = 20) were administered 30 mL of 0.5% bupivacaine and Group BM (n = 20) were given 30 mL of 0.5% bupivacaine with midazolam 50 μg·kg-1. Hemodynamic variables (i.e., heart rate, noninvasive blood pressure), pain scores and rescue analgesic requirements were recorded for 24 hr postoperatively.


The onset of sensory and motor block was significantly faster in Group BM compared to Group B (P < 0.05). Pain scores were significantly higher in Group B compared to Group BM from two hours to 24 hr postoperatively (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.


Midazolam (50 μg·kg-1) in combination with 30 mL of bupivacaine (0.5%) hastened onset of sensory and motor block, and improved postoperative analgesia when used in brachial plexus block, without producing any adverse events. Objectif : Un ajout aux anesthésiques locaux pour le bloc du plexus brachial peut améliorer la qualité et la durée de ľanalgésie. Le midazolam, une benzodiazépine hydrosoluble, administré par voie péridurale ou intrathécale, produit de ľantinociception et améliore ľeffet des anesthésiques locaux. Nous avons évalué ľeffet du midazolam ajouté à ľanesthésie du plexus brachial.


Midazolam Bupivacaine Motor Block Sensory Block Sedation Score 
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Le bloc du plexus brachial avec du midazolam et de la bupivacaïne améliore ľanalgésie



Une étude prospective, randomisée et à double insu a été menée auprès de 40 adultes ďétat physique ASA I ou II devant être opérés aux membres supérieurs sous anesthésie supraclaviculaire du plexus brachial. Les patients ont été répartis aléatoirement en deux groupes. Ceux du groupe B (n = 20) ont reçu 30 mL de bupivacaïne à 0,5 % et ceux du groupe BM (n = 20) ont eu 30 mL de bupivacaïne à 0,5 % avec 50 μg·kg-1 de midazolam. Les variables hémodynamiques, les scores de douleur et les demandes ďanalgésiques de secours ont été notés pendant 24 h après ľopération.


Le délai ďinstallation du bloc sensitif et moteur a été significativement plus court chez les patients du groupe BM, comparé au groupe B (P < 0,05). De 2 h à 24 h après ľopération, les douleurs ont été plus importantes dans le groupe B (P <0,05) et les demandes ďanalgésiques de secours ont été moindres dans le groupe BM (P < 0,05). Après ľopération, ľhémodynamique et les scores de sédation ne différaient pas ďun groupe à ľautre.


Le midazolam (50 µg·kg-1) combiné à 30 mL de bupivacaïne (0,5 %) a accéléré ľinstallation du bloc sensitif et moteur et amélioré ľanalgésie postopératoire sans produire ďeffets indésirables lors du bloc du plexus brachial.


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Copyright information

© Canadian Anesthesiologists 2005

Authors and Affiliations

  • Koj Jarbo
    • 1
  • Yatindra Kumar Batra
    • 1
    Email author
  • Mnams Nidhi
    • 1
  • Bidyut Panda
    • 1
  1. 1.Department of Anesthesia and Intensive Care UnitPostgraduate Institute of Medical Education and ResearchChandigarhIndia

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