الفهرس 
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Abstract
Background: Brachial plexus block provides a reliable and relatively safe anaesthesia for upper extremity . It can be used for high-risk patients who cannot tolerate the stress imposed by general anaesthesia. The supraclavicular approach to brachial plexus is highly practical and efficacious in achieving anesthesia of the arm,forearm and hand. Many local anesthetics can be used for brachial plexus block. Bupivacaine is used most frequently. Midazolam one of benzodiazepine which used mainly as sedative .Aim of the work: The aim of this study is to evaluate the onset of sensory and motor action of different doses of midazolam added to bupivacaine in supraclavicular brachial plexus block . Methods: 60 adult patients scheduled for forearm and hand surgery after trauma admitted to Emergency Hospital Mansoura University for upper limb extremities surgeries were included in the study. Categorizing patients in to three groups, each group contain 20 patients. Brachial plexus block was performed by a senior and experienced anesthesiologist using a supraclavicular approach. Study drugs were prepared by an anesthesiologist not involved in performing the block. Patients will be randomly assigned to three groups (n=20 in each): B group (control: Patients will receive a single dose of 30 ml of 0.5 % isobaric bupivacaine mixed with saline as placebo. BM 50 group: Patients will receive a single dose of 30 ml of 0.5 % isobaric bupivacaine mixed with midazolam 50 ?g/kg.BM100 group: patients will receive a single dose of 30 ml of 0.5 % isobaric bupivacaine mixed with midazolam 100?g/kg.Results: The results of this randomized study, demonstrated that the addition of either 50 ?g/kg or 100 ?g/kg midazolam to bupivacaine 5mg/ml for supraclavicular brachial plexus block did not improve the speed of the onset of block or increase the duration of sensory or motor block. Conclusion: From the previous results , it was concluded that the onset of sensory and motor blockade as well as the duration of post operative sensory blockade did not affected by the addition of either 50 ?g/kg or 100 ?g/kg midazolam to bupivacaine in supraclavicular brachial plexus block.