Purpose: 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.
Methods: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.
Results: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.
Conclusion: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
Electrical Discharge Machining (EDM) is a non-conventional machining process used for machining materials that are otherwise difficult to machine by conventional processes. Powder-Mixed EDM is a variant of EDM, in which an additive powder is added to the hydrocarbon dielectric. These suspended powders affect the energy distribution and sparking efficiency, and consequently the surface finish and micro-hardness. The machining operation generates a large amount of heat. Melting and fusion of these suspended powders with carbon from the hydrocarbon dielectric occur due to the heat generated. Under appropriate machining conditions, these materials may be deposited on the machined surface resulting in surface alloying and further increase in micro-hardness. In the present work, improvement in the surface characteristics after machining of AISI high-carbon high-chromium (D3) die steel with manganese powdermixed dielectric has been investigated. Results of the study show a significant improvement in micro-hardness and deterioration of surface finish. Scanning electron microscopy and X-ray diffraction of the machined surface indicates transfer of manganese and carbon in the form of manganese carbide. Quantitative analysis of the chemical composition of the machined surface was carried out on an optical emission spectrometer to verify the result.
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