A pré-medicação com midazolam antes de secção cesariana não tem efeitos adversos no neonato

Abstract

Like all surgical patients, obstetric patients also feel operative stress and anxiety. This can be prevented by giving patients detailed information about their operation and with preoperative pharmacological medications. Because of depressive effects of sedatives on newborns, pharmacological medications are omitted, especially in obstetric patients. The literature contains few studies concerning preoperative midazolam use in Caesarian section (C/S) patients. Our aim in this study was to help patients undergoing C/S surgery. One group scheduled for elective C/S received midazolam 0.025 mg kg(-1) intravenously, the other received saline. Maternal anxiety was evaluated using Amsterdam Preoperative Anxiety and Information Scale (APAIS) scores, and newborns were evaluated using Apgar and the Neonatal Neurologic and Adaptive Capacity Score (NACS). In conclusion, patients receiving midazolam 0.025 mg kg(-1) as premedication had significantly low anxiety scores, without any adverse effects on the newborns. Midazolam can therefore safely be used as a premedicative agent in C/S surgery.

Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section

“…This study has shown an association between preoperative anxiety and selection of GA, as high level of anxiety was found in patients selecting GA as compared to those opting for RA ( P < 0.05). Previous studies have shown that patients who are unable to cope with the additional challenges of being awake during surgery request GA.[ 3 11 ] In addition, fear of regional block not working and needle phobia are additional causes of anxiety preventing patients to choose RA. [ 12 ] Consequently, preoperative anxiety due to multiple reasons can affect the patient's choice of anesthesia.…”

Premedication with midazolam prior to cesarean delivery in preeclamptic parturients: A randomized controlled trial

“…In contrast, Senel and Mergan[ 18 ] gave a single iv dose of 0.025 mg/kg midazolam to parturients 30 min before cesarean delivery. They evaluated maternal anxiety using APAIS score and newborns with Apgar and NACS scores.…”

“…We chose the midazolam dose (0.035 mg/kg) based on these previous studies,[ 18 19 ] and according to our own experience with Egyptian parturients, aiming for the best degree of maternal satisfaction without causing maternal hypoventilation or neonatal depression. We chose a single bolus based on body weight; however, in clinical practice, some may prefer to titrate iv drugs to effect.…”

“…The power analysis is based on independent sample t -test and a 25% decrease of the APAIS score; the α value was 0.05 and the power (1-β) of the study was 0.80. Depending on the previous studies,[ 18 23 ] it was calculated that a minimum of 36 patients would be required per group. However, we enrolled eighty patients (40/group) to allow for drop-outs.…”

“…[ 15 16 ] More recent studies investigated the sedative effect of midazolam with or without narcotics on normal parturients. [ 17 18 19 ] However, the impact of midazolam as a sedative on preeclamptics has not been sufficiently studied prospectively. In this concern, we decided to study the maternal and neonatal outcomes of a sedative dose of midazolam in these cases.…”