Comparison of caudal bupivacaine, bupivacaine-morphine and bupivacaine-midazolam mixtures for post-operative analgesia in children

Güleç, Sacit; Büyükkıdan, Bülent; Oral, N.; Özcan, N.; Tanriverdi, Belkıs

doi:10.1046/j.1365-2346.1998.00262.x

Cited by 11 publications

(21 citation statements)

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“…17,18 In our study, sedation scores were higher in patients in Group BM compared to Group B, 15 min after injecting the drug until 30 min postoperatively. This may have been due to partial vascular uptake of the drug (midazolam), and its transport to the central nervous system where it acts and produces sedation.…”

Section: Discussionmentioning

confidence: 44%

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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: 44%

“…[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%

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

“…They attributed this neurotoxicity to low pH. Caudal epidural midazolam with pH 6.0-7.4 is safe in children [9,31]. The concentration of midazolam used in our study was 0.001% and the pH of the solution was 6.0 in Group B and 5.9 in Group BM.…”

Section: Discussionmentioning

confidence: 58%

“…Epidural midazolam in bolus (50-100 μg/kg) dose provides effective pain relief and prolongs the time to requesting analgesia in children [9][10][11] as well as in adults [16,17]. When used in these doses (especially N 75 μg/kg bolus), epidural midazolam is associated with systemic side effects, such as a decrease in RR, excessive sedation [16], and airway obstruction requiring assistance [17].…”

Section: Discussionmentioning

confidence: 99%

“…An epidural infusion of midazolam has been used in adults and causes amnesia and sedation [6][7][8]. "Single shot" caudal epidural injection of midazolam prolongs the analgesic effect of bupivacaine in children [9][10][11], but we have found no published data on the effect of epidural infusion of midazolam. This study investigated the analgesic effect and side effects of adding midazolam to continuous epidural infusion of bupivacaine for postoperative analgesia in children undergoing upper abdominal and flank surgery.…”

Section: Introductionmentioning

confidence: 90%

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