الفهرس 
Anatomy of the Brachial PlexusOnly 14 pages are availabe for public view
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Abstract
Background: Poorly controlled surgical pain is associated with a variety of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stays and an increased likelihood of chronic pain. Systemic analgesics (opioids and non-opioids) have long been used for postoperative pain, then neuroaxial or peripheral nerve blocks were employed. Local anesthetics alone were used, then various adjuvants were added to achieve quick, dense and prolonged block. Aim of the Work: The aim of this work is to evaluate the efficacy of midazolam-bupivacaine combination compared to plain bupivacaine (0.5%) for brachial plexus block. Patients and Methods: After obtaining approval from the Research Ethical Committee of Ain Shams University, this study was conducted in the operating theatres of Ain Shams University Hospital. Study Design: Prospective double-blinded, randomized controlled trial.50 patients were divided in to two groups each group contained 25 patients:
- group A (Control group): Patients received 30 ml of 0.5% Bupivacaine + 2 ml of Normal Saline 0.9%
- group B (Midazolam group): Patients received 30 ml of 0.5% bupivacaine + Midazolam 0.05 mg/kg,
Results: Midazolam group had faster time of onset of sensory & motor block compared to the control group with a significant statistically difference (P < 0.001) & (P = 0.013) respectively. The duration of sensory block was shorter in control group compared to Midazolam group with a highly significant statistical difference (P < 0.001). Midazolam had longer duration of motor block compared to control group with non significant difference (P = 0.259). As regards duration of analgesia of the block there was a highly significant difference between midazolam and control group (P < 0.001). As regards assessment of the Sedation score, patients in midazolam group have got a sedation score more than that in the control group with a highly statistically significant difference (P < 0.001). Regarding assessment of post-operative pain, there was highly significant difference between midazolam group compared to the control group as regards the total pethidine doses in mg taken by each group (P < 0.001). Conclusion: In the current study, addition of Midazolam to bupivacaine in supraclavicular nerve block shortened the onset times of both sensory and motor blocks, also it significantly prolonged both sensory and motor block durations and post operative analgesia.