Evaluation of midazolam as an adjuvant to bupivacaine in supraclavicular brachial plexus block

Background The duration of the supraclavicular brachial plexus block is limited by the duration of action of local anesthetic used for the block. Many adjuvants are used to prolong the duration of the block. Few studies were carried on evaluate the effects of using midazolam as an adjuvant to bupivacaine in supraclavicular brachial plexus block.Aim The aim of the study was to evaluate the anesthetic characteristics of adding midazolam to bupivacaine during ultrasound-guided supraclavicular brachial plexus block.Patients and methods The study was carried out on 96 patients scheduled for upper limb surgeries. They were divided into three equal groups to receive ultrasound-guided supraclavicular brachial plexus block using 30 ml bupivacaine 0.5% in group I, 30 ml bupivacaine 0.5% and 30 µg/kg midazolam in group II, and 30 ml bupivacaine 0.5% in addition to 30 µg/kg intravenous midazolam in group III.Results The onset of sensory and motor block were significantly faster, and the durations were significantly longer in group II compared with groups I and III; furthermore, postoperative analgesia was significantly prolonged in group II (P<0.05). Patients of group II had prolonged mild sedation compared with group III.Conclusion Midazolam is a valuable adjuvant to bupivacaine during ultrasound-guided supraclavicular brachial plexus block, which requires further evaluation.