A Randomized Comparison Between Midazolam and Thiopental for Elective Cesarean Section Anesthesia. III. Placental Transfer and Elimination in Neonates

Bach, V.; Carl, P; Ravlo, O; Crawford, Michael E.; Jensen, Anders Gadegaard; Mikkelsen, B; Crevoisier, C; Heizmann, P.; Fattinger, Karin

doi:10.1097/00132586-198908000-00019

Cited by 20 publications

(14 citation statements)

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“…With this dose umbilical artery levels are much lower than the umbilical venous levels. 40,41 Therefore; as anticipated, the preferred thiopental dose (2 mg/kg) in our study did not lower the Apgar scores of the newborns either at 1 st or 5 th minutes.…”

Section: Discussionsupporting

confidence: 78%

Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension in Preoperatively Anxious Parturients Underwent Urgent Category-1 Cesarean Section: A Historical Cohort Study

Şahan¹,

Şalvız²,

Alay³

et al. 2017

Turkiye Klinikleri J Anest Reanim

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : This study was designed to investigate the effect of sedation on maternal hypotension in preoperatively anxious parturients underwent urgent category-1 Cesarean section (C/S) under spinal anesthesia (SA). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : After ethics committee approval, data of 1824 parturients underwent C/S were reviewed from the surgical database and patient charts. Parturients with high preoperative anxiety scores (VAS-A)≥70) underwent C/S under SA with thiopental 2 mg/kg (if necessary additional 50 mg) sedation until reaching Ramsay sedation score≥3 (Group S, n=49), and without any other type of sedation (Group NS, n=53) were included in the study. All parturients received SA with hyperbaric bupivacaine 0.5% 2.5 mL. Hemodynamic parameters and maximum systolic arterial pressure (SAP) reductions (%) from the baseline were recorded. Maternal hypotension (SAP≥30% decrease or <100 mmHg) and bradycardia (heart rate <55 beats/min) incidences, required ephedrine (5mg IV bolus) and atropine (0.5 mg IV bolus) doses, and newborn Apgar scores were also analyzed. R Re es su ul lt ts s: : Fifty-nine parturients' data (Group S: 29 and Group NS: 30) were analyzed. The maximum SAP reductions were 23±12.8% and 30.8±16.1% in Groups S and NS, respectively (p=0,044). Hypotension was observed in 5 (17,2%) parturients of Group S and 15 (50%) of Group NS (p=0.012, 95% CI 0,14-0,82; relative risk=0,344). Ephedrine requirement was 17±4,4 mg and 25±7,4 mg in Groups S and NS, respectively (p=0,04). Incidence of bradycardia, required atropine dose and newborn Apgar scores were similar in both groups (p>0,05). C Co on nc cl lu us si io on ns s: : The maximum SAP reduction, hypotension incidence and required ephedrine doses were lower in thiopental sedation used preoperatively anxious parturients who underwent category-1 C/S under SA. K Ke ey yw wo or rd ds s: : Cesarean section; anxiety; anesthesia, spinal; conscious sedation; thiopental Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma, preoperatif dönemde anksiyöz olup spinal anestezi (SA) altında acil kategori-1 sezaryen (C/S) operasyonu geçiren gebelerde, sedasyonun hipotansiyona etkisini araştırmak için planlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Etik kurul onayı alındıktan sonra, C/S operasyonu geçiren 1824 gebenin verileri cerrahi arşiv ve hasta dosyaları aracılığıyla incelendi. Preoperatif anksiyete skoru (VAS-A)≥70) yüksek olup SA altında C/S geçiren gebelerden Ramsay sedasyon skoru ≥3 olacak şekilde tiyopental 2 mg/kg (gereğinde 50 mg ek doz) uygulanan hastalar (Grup S, n=49) ve herhangi bir sedasyon uygulanmayan hastalar (Grup NS, n=53) çalışmaya dahil edildi. Tüm gebelere, 2,5mL %0,5'lik hiperbarik bupivakain ile SA uygulandı. Hemodinamik parametreler ve bazale göre sistolik arteryal basınçtaki (SAB) maksimum düşüşler (%) kaydedildi. Maternal hipotansiyon (SAB'ın ≥%30 düşmesi veya <100 mmHg olması) ve bradikardi (kalp hızı <55 atım/dk) insidansları, efedrin gereksinimi (5 mg IV b...

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Section: Discussionsupporting

confidence: 78%

Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension in Preoperatively Anxious Parturients Underwent Urgent Category-1 Cesarean Section: A Historical Cohort Study

Şahan¹,

Şalvız²,

Alay³

et al. 2017

Turkiye Klinikleri J Anest Reanim

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“…In the fi rst month of life, the dose of thiopental is 45 % less than it is in older infants 1-6 months of age, probably attributable to the reduced protein binding, more permeable blood-brain barrier, and increased brain sensitivity to thiopental [ 150 ]. However, the elimination halflife of thiopental in neonates exceeds 14 h, 2.5-fold greater than midazolam [ 152 ]. When administered with succinylcholine, thiopental increases the success rate and shortens the time interval to tracheal intubation [ 128 ].…”

Section: Anesthetic Agents For Rsimentioning

confidence: 99%

Selection of Anesthesia Techniques for the Neonate

Sabourdin

Louvet

Constant

2014

Neonatal Anesthesia

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“…The duration of diazepam-induced hypnosis at night surpasses that of midazolam, especially due to the presence of several active metabolites, such as desmethyldiazepam. In NB, midazolam has a halflife of 6.3 h, and thiopental, 14.7h [65][66][67] .…”

Section: Benzodiazepinesmentioning

confidence: 99%

O tempo e a anestesia obstétrica: da cosmologia caótica à cronobiologia

Vale¹,

Vale²,

Cruz³

2009

Rev. Bras. Anestesiol.

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CONTENTS: Chronobiological analysis of the main events in the obstetric pathophysiology of Mulier sapiens: I) Embryogenesisrisk of teratogenesis; II) From prematurity to post-didacticism: from eutocic labor to cervical cerclage; III) Night and labor: higher incidence of nocturnal labor (physiological facilitation) and daylight cesarean section (choice of the obstetrician); IV) The moon and labor -non-conclusive results; V)

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A Randomized Comparison Between Midazolam and Thiopental for Elective Cesarean Section Anesthesia. III. Placental Transfer and Elimination in Neonates

Cited by 20 publications

References 0 publications

Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension in Preoperatively Anxious Parturients Underwent Urgent Category-1 Cesarean Section: A Historical Cohort Study

Effects of Sedation on Spinal Anesthesia-induced Maternal Hypotension in Preoperatively Anxious Parturients Underwent Urgent Category-1 Cesarean Section: A Historical Cohort Study

Selection of Anesthesia Techniques for the Neonate

O tempo e a anestesia obstétrica: da cosmologia caótica à cronobiologia

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