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REGIONAL ANESTHESIA AND PAIN MEDICINE

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

Brian P. Kinirons, FFARCSI^*, Hervé Bouaziz, MD, PhD, Xavier Paqueron, MD, Adil Ababou, MD, Céline Jandard, MD, My Maï Cao, MD^§, Marie-Lorraine Bur, MD, Marie-Claire Laxenaire, MD, and Dan Benhamou, MD

*Department of Anesthesiology and Intensive Care, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin Bicêtre Cedex; Department of Anesthesiology and Intensive Care, Hôpital Central, Nancy Cedex; Department of Anesthesiology and Intensive Care, Hôpital Antoine Béclère, Clamart Cedex; §Department of Clinical Epidemiology and Evaluation, Hôpital Marin, Nancy Cedex, France

Address correspondence and reprint requests to Dr. Hervé Bouaziz, Hôpital Central, 54035 Nancy Cedex, France. Address e-mail to h.bouaziz{at}chu-nancy.fr

Multiple nerve blocks may be painful and a source of discomfort. We assessed the efficacy of sufentanil 5 µg 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.

Implications: In a prospective trial of 168 patients, the use of sedation significantly reduced pain during a multiple-nerve stimulation block. The combination of sufentanil and midazolam produced either minimal or no sedation and allowed the performance of the block in awake and cooperative patients. Light sedation may improve patient acceptance of this technique

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