Document Type : Original Article
Authors
Department of Anesthesia, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Objective: This study was designed to evaluate the effect of different doses of midazolam
on anesthesia and analgesia quality when added to lidocaine during the intravenous regional
anesthesia (IVRA).
Methods: One hundred and forty patients underwent hand surgery were randomly allocated
into four groups to receive 3 mg/kg lidocaine 2% diluted with saline to a total volume of
40 mL in the control Group L‑C (n = 35), 30 µg/kg midazolam plus 3 mg/kg lidocaine 2%
diluted with saline to a total volume of 40 mL in the midazolam Group L‑M1 (n = 35), 40 µg/kg
midazolam plus 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the
midazolam Group L‑M2 (n = 35), and 50 µg/kg midazolam plus 3 mg/kg lidocaine 2% diluted
with saline to a total volume of 40 mL in the midazolam Group L‑M3 (n = 35). Sensory and
motor block and recovery times, tourniquet pain, intra‑operative analgesic requirement, and
visual analog scale (VAS) scores were recorded.
Findings: Onset time of sensory and motor block in L‑M3
Group was shorter than the
L‑M2
and L‑M1
and L‑C Groups (P < 0.001). Furthermore, prolonged sensory (P = 0.005) and
motor recovery time (P = 0.001) in L‑M3
were longer than the other groups. Intra‑operative
VAS score and intra‑operative fentanyl consumption in L‑M3
were lower than the other
groups (P < 0.001). The numbers of patients needed to pethidine in Group L‑M3
were
significantly less compared with the other groups (P = 0.035). VAS scores were significantly
lower in Group L‑M3
in different time intervals in the postoperative period compared with
the other groups (P < 0.001).
Conclusion: Addition of 50 µg/kg midazolam for IVRA (Group L‑M3
) enhanced
intra‑operative analgesia and improved anesthesia quality better than other groups receiving
lower midazolam doses as well as a control group.
Keywords
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