Sedation with Sufentanil and Midazolam Decreases Pain in Patients Undergoing Upper Limb Surgery Under Multiple Nerve Block

Abstract

Multiple nerve blocks may be painful and a source of discomfort. We assessed the efficacy of sufentanil 5 microg combined with midazolam 1 mg in decreasing pain in outpatients after a midhumeral multiple nerve stimulation technique. Visual analog scores for pain were significantly lower in those patients who received sedation before the block, both at the time of block performance (14 +/- 1 vs 27 +/- 2 mm, P < 0.0001) and at discharge (11 +/- 1 vs 24 +/- 2 mm, P < 0. 0001). We conclude that the association of sufentanil and midazolam produced minimal sedation while significantly reducing pain experienced by patients undergoing multiple nerve stimulation.

Patient comfort during regional anesthesia

“…Patient acceptance of subsequent regional anesthetic techniques is dependent on previous experience [9]. These experiences should be elicited and discussed [10,11]. Preanesthetic videos may improve the effectiveness of traditional preanesthetic consultation practices [12].…”

Use of a nerve stimulator does not improve the efficacy of ultrasound-guided supraclavicular nerve blocks

“…Given that multiple needle passes seeking a nerve stimulation response or a paresthesia have been implicated in increasing the risks for neuropraxia, patient anxiety, and patient dissatisfaction [2][3][4], the observation that a needle may be physically touching a nerve without evoking a response is disconcerting. Therefore, the major objectives of this database review were to define the frequency of failed nerve stimulation during ultrasound guidance and to determine whether a successful motor response to nerve stimulation predicts a successful block.…”

The Effect of Intravenous Midazolam on Duration of Spinal Anesthesia

“…Moreover, sedation reduces postoperative recall and increases global tolerance and acceptance of a regional block (7). In addition, continuous sedation can improve comfort, particularly during uncomfortable positioning and time-consuming surgery (8).…”