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KMID : 0356920080540020167
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Korean Journal of Anesthesiology
2008 Volume.54 No. 2 p.167 ~ p.172
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The Effect of the Addition of Fentanyl and Midazolam to Lidocaine in a Supraclavicular Brachial Plexus Block
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Kim Min-Soo
Hwang Bum-Sang
Hwang Byeong-Mun
Kang Seong-Sik
Son Hee-Jeong
Jung Il-Young
Lee Hey-Jean
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Abstract
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Background:This study was conducted to evaluate the effects of fentanyl and midazolam when used as adjuvant in a supraclavicular brachial plexus block.
Methods:100 adult patients with an ASA status of I?II that were scheduled to undergo upper extremity surgery performed under a supraclavicular brachial plexus block were prospectively evaluated in this study.The patients were randomly divided into 4 study groups:Group 1, which received 40 ml of 1.5% lidocaine, Group 2, which received 3 mg of midazolam with 40 ml of 1.5% lidocaine, Group 3, which received 100?g of fentanyl with 40 ml of 1.5% lidocaine, and Group 4, which received 3 mg of midazolam and 100?g of fentanyl with 40 ml of 1.5% lidocaine.The onset time, as well as the duration of analgesia and motor blocks, proportion of successful blocks, hemodynamic parameters, and adverse events were then noted.
Results:The incidence of successful block was higher in group 4 (92%) than in any other groups (68?72%) (P = 0.185). In addition, the mean duration of analgesia was longer in groups 2 and 4 (165 min and 175 min) than in groups 1 and 3 (114 min and 131 min) (P ＜ 0.05).Furthermore, the mean duration of motor block was longer in groups 2 and 4 (169 min and 180 min) than in groups 1 and 3 (123 min and 126 min) (P ＜ 0.05).No significant difference was observed in the onset time of the sensory block and motor block when the groups were compared.
Conclusion:Although the addition of 3 mg of midazolam and 100?g of fentanyl to lidocaine in a supraclavicular brachial plexus block does not affect the onset of sensory or motor block, it does prolong the duration of analgesia and motor block.(Korean J Anesthesiol 2008; 54: 167∼72)
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KEYWORD
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fentanyl, lidocaine, midazolam, supraclavicular brachial plexus block
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