On the Mechanism by Which Midazolam Causes Spinally Mediated Analgesia

Edwards, Megan; Serrao, Juliet M; Gent, J P; Goodchild, Colin S

doi:10.1097/00000542-199008000-00015

Cited by 142 publications

(84 citation statements)

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“…This could be due to a local anesthetic property of midazolam and its synergistic action with that of local anesthetics. [10][11][12] The onset of motor block was found to be faster than the onset of sensory block in both groups. Winnie et al 16 observed this also, and attributed this to the Group B = were administered bupivacaine; Group BM = were administered bupivacaine and midazolam.…”

Section: Discussionmentioning

confidence: 80%

“…[10][11][12] Gulec et al 17 found that a bupivacaine and midazolam combination prolonged postoperative analgesia compared to a bupivacaine-morphine combination when administered caudally. Nishiyama et al 11 added midazolam to a continuous epidural infusion of bupivacaine and observed improved analgesia.…”

Section: Discussionmentioning

confidence: 99%

“…Midazolam produces this additive effect on local anesthetics by its action on the GABA-A receptor complexes present in the spinal cord. [10][11][12] The addition of midazolam in doses of approximately 1 to 2 mg intrathecally has a positive effect on perioperative and chronic pain therapy. 19 Studies in animals have revealed no neurotoxic effects of intrathecally administered midazolam.…”

Section: Discussionmentioning

confidence: 99%

“…Midazolam produces this effect by its action on gamma aminobutyric acid-A (GABA-A) receptors. [10][11][12] GABA receptors have also been found in peripheral nerves. [13][14][15] However, the effect of adding midazolam to a local anesthetic solution in peripheral nerve blocks has not been studied.…”

Section: Conclusion : Le Midazolam (50 µG·kg -1 ) Combiné à 30 ML De mentioning

confidence: 99%

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Brachial plexus block with midazolam and bupivacaine improves analgesia

Jarbo

Batra

Nidhi

et al. 2005

Can J Anesth/J Can Anesth

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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

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Conclusion : Le Midazolam (50 µG·kg -1 ) Combiné à 30 ML De mentioning

confidence: 99%

See 2 more Smart Citations

Brachial plexus block with midazolam and bupivacaine improves analgesia

Jarbo

Batra

Nidhi

et al. 2005

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…Midazolam exerts its analgesic activity through benzodiazepine receptors, which are distributed in the gray matter of the cervical, thoracic, lumbar, and sacral regions of the spinal cord; the highest densities of receptors were localized within lamina II of the dorsal horn (17). The segmental analgesia produced by intrathecal midazolam is mediated by the benzodiazepine GABA receptor complex, which is also involved in other benzodiazepine actions (18). It has further been argued that intrathecal midazolam reduces excitatory GABA-mediated neurotransmission in interneurons, leading to a decrease in the excitability of spinal dorsal horn neurons (19).…”

Section: Discussionmentioning

confidence: 99%