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. 2011 Sep;16(9):1139-48.

The analgesic effect of midazolam when added to lidocaine for intravenous regional anaesthesia

Parviz Kashefi  1 , Kamran Montazeri, Azim Honarmand, Mohammadreza Safavi, Hashem Mirzaee Hosseini
Affiliations

The analgesic effect of midazolam when added to lidocaine for intravenous regional anaesthesia

Parviz Kashefi et al. J Res Med Sci. 2011 Sep.

Abstract

Background: Midazolam has analgesic properties. The aim of the present study was to assess the analgesic effect of midazolam when added to lidocaine in intravenous regional anesthesia (IVRA).

Methods: Sixty patients undergoing hand surgery were randomly allocated into two groups to receive 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the control group (group lidocaine saline ~ LS, n=30) or 50 μg/kg midazolam plus 3 mg/kg 2% lidocaine diluted with saline to a total volume of 40 mL in the midazolam group (group lidocaine midazolam ~ LM, n=30). Before and after the tourniquet application, hemodynamic variables, tourniquet pain, sedation, and analgesic use were recorded.

Results: Shortened sensory and motor block onset time [4.20 (0.84) vs. 5.94 (0.83) min, p = 0.001 and 6.99 (0.72) vs. 9.07 (0.99) min, p = 0.001 in LM and LS groups, respectively], prolonged sensory and motor block recovery times [8.41 (0.94) vs. 5.68 (0.90) min, p = 0.001 and 11.85 (1.18) vs. 7.06 (0.82) min, p = 0.001 in LM and LS groups, respectively], shortened visual analog scale (VAS) scores of tourniquet pain (p < 0.05), and improved quality of anesthesia were found in group LM (p < 0.05). VAS scores were lower in group LM in the postoperative period (p = 0.001). Postoperative analgesic requirements were significantly smaller in group LM (p = 0.001).

Conclusions: The addition of 50 μg/kg midazolam to lidocaine for IVRA shortens the onset of sensory and motor block, and improves quality of anesthesia and perioperative analgesia without causing side effects.

Keywords: Anaesthetic Techniques; Analgesics; IV Regional Lidocaine; Midazolam; Postoperative; Tourniquet Pain.

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Conflict of interest statement

Conflict of Interests Authors have no conflict of interests.

Figures

Figure 1
Figure 1
Intraoperative (tourniquet pain) and postoperative visual analogue scale scores. Data are presented as mean (SD). Group LS = lidocaine-saline group; Group LM = lidocaine-midazolam group. ATI = after tourniquet inflation; ATR = after tourniquet release
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