Effect of Midazolam and Dexmedetomidine Sedation on the Onset and Duration of Supraclavicular Brachial Plexus Block:  A Randomised Comparative Study

Kumar, Gunjan; Dubey, Prakash K.; Sanjeev, Om Prakash

doi:10.5152/tjar.2018.57355

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…h -1 . Midazolam is a benzodiazepine used for intraoperative sedation, having anxiolytic, amnesic and sedative properties, along with a low incidence of unpredictable outcomes and a vast margin of safety [8]. The axillary block was done in the supine position with the arm abducted to 90° and the hand lying on the bed next to the head.…”

Section: Resultsmentioning

confidence: 99%

Open Carpal Tunnel Release:Performed Axillary Brachial Plexus Block vs. Wide Awake

Răducu¹,

Avino²,

Cozma³

et al. 2019

Rev. Chim.

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Section: Resultsmentioning

confidence: 99%

Open Carpal Tunnel Release:Performed Axillary Brachial Plexus Block vs. Wide Awake

Răducu¹,

Avino²,

Cozma³

et al. 2019

Rev. Chim.

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“…Although the approach to brachial plexus, dose and combination of local anesthetic that is used is different our results are in parallel with this research. 19 Dexmedetomidine infusion during surgery reduces post-operative pain, opioid consumption, and the risk of opioid-related adverse events independent from anesthetic choice. 20 The mechanism by which dexmedetomidine prolongs the duration of nerve block involves local vasoconstriction; spinal, supraspinal, and direct action on the nerve; and systemic effects.…”

Section: Discussionmentioning

confidence: 99%

Comparing Effects of Midazolam and Dexmedetomidine Sedation on Ultrasound Guided Infraclavicular Nerve Block for Upper Extremity Orthopedic Surgeries

Çiftçi¹,

Altan²

2019

Turkiye Klinikleri J Anest Reanim

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Sedation is an important step of regional anesthesia, the effects of sedative agents on nerve block characteristics are often subjects of scientific researches. In our study, we aimed to compare the effects of dexmedetomidine and midazolam sedation on sensory and motor onset and termination time after infraclavicular nerve block. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : After local ethics committee approval and patients written informed consents were obtained, 60 patients between the ages of 18-65 years, with an American Society of Anesthesiologists (ASA) classification I-II who received infraclavicular nerve block randomized into two groups. Group D received 0.8 μg/kg bolus continued with 0.2-0.7 μg/kg/h of maintenance dose of dexmedetomidine group M received 0.05mg/kg bolus continued with 0.02-0.2 mg/kg/h of maintenance dose of midazolam. The patient's demographic data heart rate pulse, mean arterial pressure, sensory and motor block onset and termination time were analyzed. R Re es su ul lt ts s: : Heart rate and mean arterial pressure were lower in dexmedetomidine group. Sensory (Group D: 8.6±2.4 Group M: 16.2±1.8) and motor block onset time (Group D: 14.2±1.6, Group M: 21.4±2.3) was shorter in dexmedetomidine group. Sensory (Group D: 715.4±41.1 min Group M: 518.1±44.2 min) and motor block termination time (Group D: 613.6±38.1 min Group M: 421.3±37.2 min) were longer in dexmedetomidine group. C Co on nc cl lu us si io on n: : The use of dexmedetomidine for sedation on patients who received ultrasound-guided infraclavicular block for upper extremity surgeries resulted earlier onset time to sensory and motor block and prolonged sensory and motor block termination time. K Ke ey yw wo or rd ds s: : Dexmedetomidine; midazolam; infraclavicular nerve block Ö ÖZ ZE ET T A Am ma aç ç: : Rejyonel anestezinin önemli bir basamağı olan sedasyon amacıyla kullanılan sedatif ajanların sinir bloğu karakteristiğine etkileri sıklıkla bilimsel araştırmalara konu olmaktadır. Çalışmamızda, deksmedetomidin ve midazolam ile sedasyonun infraklaviküler sinir bloğu başlama ve sonlanma zamanına etkilerini karşılaştırmayı amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Yerel etik kurul onayı ve yazılı bilgilendirilmiş onam formu alındıktan sonra, 18-65 yaş aralığında, Amerikan Anesteziyologlar Birliği (ASA) I-II grubu İnfraklaviküler blok yapılacak 60 hasta randomize edilerek iki gruba ayrıldı. Grup D'ye sedasyon amacıyla 0,8 μg/kg deksmedetomidin bolus sonrasında 0,2-0,7 μg/kg/saat idame tedavi verildi, Grup M'ye 0,05 mg/kg midazolam bolus sonrasında 0,02-0,2 mg/kg/saat idame tedavi verildi. Hastaların demografik verileri, kalp tepe atımı, ortalama arteriyel basınç, duyusal ve motor blok başlama ve sonlanma zamanı analiz edildi. B Bu ul lg gu ul la ar r: : Grupların demografik verileri benzerdir, kalp tepe atımı ve ortalama arteriyel basınç deksmedetomidin grubunda daha düşük bulundu.

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“…2Using additive drugs in local anesthetic can reduce the dosage of local anesthetic drugs for nerve block and reduce the probable side effects of these drugs, and increasing the benefits of adjuvant drugs can be used. e new drugs have been used in this field, including buprenorphine [9], dexamethasone [10], magnesium [11], and midazolam [12]. e use of these drugs to reduce onset block time, increasing the duration time of analgesia without incidence of unwanted systemic complications, motor block prolongation, and finally reducing the total dose of local anesthetics drugs, has been proposed and studied.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have been conducted on the use of local anesthetics with additive agents [3,[9][10][11][12]20]. However, a unit drug for adding local anesthetic to improve block quality is not recommended [3,20,21].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Dexmedetomidine in Combination with Bupivacaine on Sensory and Motor Block Time and Pain Score in Supraclavicular Block

Sane

Shokouhi

Golabi

et al. 2021

Pain Research and Management

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Background. Brachial plexus block is frequently recommended for upper limb surgeries. Many drugs have been used as adjuvants to prolong the duration of the block. This study aimed to assess the effect of dexmedetomidine with bupivacaine combination and only bupivacaine on sensory and motor block duration time, pain score, and hemodynamic variations in the supraclavicular block in upper extremity orthopedic surgery. Methods. This prospective, double-blind clinical trial study was conducted on 60 patients, 20 to 60 years old. Patients were candidates for upper extremity orthopedic surgeries. The sensory and motor block were evaluated by using the pinprick method and the modified Bromage scale. The postoperative pain was assessed by utilizing a visual analog scale. Results. The mean onset time of sensory and motor block in patients receiving only bupivacaine was, respectively, 31.03 ± 9.65 min and 24.66 ± 9.2 min, and in the dexmedetomidine receiving group, it was about 21.36 ± 8.34 min and 15.93 ± 6.36 minutes. The changes in heart rate and mean arterial blood pressure were similar in both groups. The duration of sensory and motor block and the time of the first analgesia request in the intervention group were longer. Postoperative pain was lower in the intervention group for 24 hours ( P = 0.001). Conclusion. Dexmedetomidine plus bupivacaine reduced the onset time of sense and motor blocks and increased numbness and immobility duration. Also, dexmedetomidine reduced postoperative pain significantly with the use of bupivacaine for supraclavicular blocks. Trial Registration. IRCT, IRCT20160430027677N15. Registered 05/28/2019, https://www.irct.ir/trial/39463.

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Effect of Midazolam and Dexmedetomidine Sedation on the Onset and Duration of Supraclavicular Brachial Plexus Block: A Randomised Comparative Study

Abstract: Intravenous dexmedetomidine in combination with 25 mL of bupivacaine (0.5%) accelerated the onset of sensory and motor block and prolonged the duration of sensory and motor block when used for brachial plexus block, without resulting in any adverse events.

Cited by 8 publications

References 13 publications

Open Carpal Tunnel Release:Performed Axillary Brachial Plexus Block vs. Wide Awake

Open Carpal Tunnel Release:Performed Axillary Brachial Plexus Block vs. Wide Awake

Comparing Effects of Midazolam and Dexmedetomidine Sedation on Ultrasound Guided Infraclavicular Nerve Block for Upper Extremity Orthopedic Surgeries

The Effect of Dexmedetomidine in Combination with Bupivacaine on Sensory and Motor Block Time and Pain Score in Supraclavicular Block

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