Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia

Farouk, Sherif; Aly, Ansam

doi:10.1007/s00540-010-1015-1

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…Intrathecal bupivacaine with midazolam as an adjunct prolonged postoperative analgesia compared with bupivacaine alone for patients undergoing caesarean delivery [130], lower abdominal surgery [131], lower limb and gynaecological procedures [132]. When midazolam was mixed with lidocaine for intravenous regional anaesthesia, no significant changes to sensory or motor block onsets were observed but patients experienced enhanced intra-operative and postoperative analgesia [133]. A faster onset of sensory anaesthesia was observed when lidocaine was combined with midazolam in peribulbar block [134].…”

Section: The Physical Compatibility Of Midazolam With Localmentioning

confidence: 99%

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

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Summary Various techniques have been explored to prolong the duration and improve the efficacy of local anaesthetic nerve blocks. Some of these involve mixing local anaesthetics or adding adjuncts. We did a literature review of studies published between 01 May 2011 and 01 May 2021 that studied specific combinations of local anaesthetics and adjuncts. The rationale behind mixing long‐ and short‐acting local anaesthetics to hasten onset and extend duration is flawed on pharmacokinetic principles. Most local anaesthetic adjuncts are not licensed for use in this manner and the consequences of untested admixtures and adjuncts range from making the solution ineffective to potential harm. Pharmaceutical compatibility needs to be established before administration. The compatibility of drugs from the same class cannot be inferred and each admixture requires individual review. Precipitation on mixing (steroids, non‐steroidal anti‐inflammatory drugs) and subsequent embolisation can lead to serious adverse events, although these are rare. The additive itself or its preservative can have neurotoxic (adrenaline, midazolam) and/or chondrotoxic properties (non‐steroidal anti‐inflammatory drugs). The prolongation of block may occur at the expense of motor block quality (ketamine) or block onset (magnesium). Adverse effects for some adjuncts appear to be dose‐dependent and recommendations concerning optimal dosing are lacking. An important confounding factor is whether studies used systemic administration of the adjunct as a control to accurately identify an additional benefit of perineural administration. The challenge of how best to prolong block duration while minimising adverse events remains a topic of interest with further research required.

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Section: The Physical Compatibility Of Midazolam With Localmentioning

confidence: 99%

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Nestor

Sepúlveda

et al. 2021

Anaesthesia

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“…In cases where midazolam was added to lidocaine for intravenous regional anesthesia, it was shown to improve the quality of anesthesia and enhance intraoperative and postoperative analgesia without causing side effects [16].…”

Section: Favorable Effects In Anesthesiamentioning

confidence: 99%

Perioperative benzodiazepine use in the pediatric population: A narrative review

Andrade¹,

Marcelino²,

Zúñiga³

et al. 2023

Rev. chil. anest.

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Background: Pediatric patients undergoing surgery under anesthesia may experience anxiety and distress during the perioperative period, for which benzodiazepines (BZD) can be employed as premedication in these scenarios. For this reason, it is important to highlight the pharmacological profile, use, and possible side effects in the pediatric perioperative population. Methods: Narrative Review using the Pubmed, Scopus and Embase databases for articles between 2000 and 2021 in English and Spanish using the keywords "Benzodiazepines", "Pediatric Anesthesiology", "Pharmacology", "Adverse Effects", and "Cerebral Apoptosis" Results: The principal side effects seen with BZD use in children mainly revolves around neurological manifestations, which include sedation, respiratory depression and prolonged awakening. There is evidence on the effectiveness of BZD in the pediatric population, which is used in a limited number of situations, such as surgical procedures that trigger acute anxiety. Conclusion: BZD has been widely studied in the literature, however it is important to highlight the possible complications and level of safety in the pediatric population. It has been evidenced that prolonged treatments not only increase the severity of neurodegeneration in the most vulnerable cerebral regions, but also trigger certain connectomic pathologies through wallerian and transneuronal degeneration.

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“…Yapılan çalışmalarda midazolamın farklı etki mekanizmaları ile analjezi sağladığının gösterilmesinden yola çıkarak, bu çalışmada rejyonel intravenöz anestezide lidokaine eklenen midazolamın blok kalitesi üzerine etkilerini görmeyi amaçladık. (14). Sonuçlar da anlamlılık p<0,05 ve p<0,01 düzeyinde değerlendirildi.…”

Section: Introductionunclassified

Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması

Yaşar¹,

Bilir

Ceyhan

et al. 2018

Osmangazi̇ Journal of Medicine

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Özet: Rejyonel intravenöz anestezide (RİVA) kullanılacak ideal ajan ile ilgili net bir yaklaşım yoktur. Lokal anestezik ajanlara çeşitli adjuvanlar eklenerek RİVA kalitesi artırılmaya ve lokal anestezik yan etkilerinden kaçınılmaya çalışılmaktadır. Bu çalışmada RİVA sırasında lidokaine eklenen midazolamın blok kalitesi üzerine etkilerinin araştırılması amaçlanmıştır.Üst ekstremite cerrahisi geçirecek yaşları 18-60 yaş arasındaki hastalar rastgele 2 gruba ayrıldı. Opere olacak kol yukarıya kaldırılarak venöz boşalma yapıldıktan sonra çift kaflı turnike yerleştirildi, turnikenin şişirilmesini takiben el sırtındaki venöz kanülden kontrol grubuna (Grup K) 40 ml volümde 3 mg/kg %2'lik lidokain, midazolam grubuna (Grup M) ise toplamda 40 ml volümde 3 mg/kg %2'lik lidokain içinde 50 μg/kg midazolam enjekte edildi. Turnike süresi, oluşan duyusal ve motor blok, duysal ve motor blok dönme zamanı, intraoperatif ağrı seviyesi ve postoperatif ilk analjezik ihtiyaç zamanı kayıt edildi.Turnike süresi ve intraoperatif ağrı seviyeleri açısından gruplar arasında fark saptanmadı. Duysal ve motor blok başlama zamanı Grup M'de daha kısa bulundu (p:0.000). Motor blok dönme zamanı Grup M'de daha kısa idi (p:0.003). Postoperatif ilk analjezik ihtiyaç zamanının Grup K'da daha önce olduğu gözlendi (Grup K:74.678, Grup M: 86.123 dakika). Lidokaine midazolam eklenerek uygulanan RİVA da herhangi bir yan etki ile karşılaşılmadan daha hızlı başlangıçlı bir anestezi ve analjezi elde edilmiştir.

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Quality of lidocaine analgesia with and without midazolam for intravenous regional anesthesia

Abstract: Addition of midazolam to lidocaine for IVRA improves anesthesia quality and enhances intraoperative and postoperative analgesia without causing side effects.

Cited by 6 publications

References 28 publications

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Pharmacological and clinical implications of local anaesthetic mixtures: a narrative review

Perioperative benzodiazepine use in the pediatric population: A narrative review

Rejyonel İntravenöz Anestezide Lidokain ve Lidokain-Midazolamın Etkinliklerinin Karşılaştırılması

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