A single dose of fentanyl and midazolam prior to Cesarean section have no adverse neontal effects

Frölich, Michael A.; Burchfield, David J.; Euliano, T. Y.; Caton, Donald

doi:10.1007/bf03021531

Cited by 51 publications

(25 citation statements)

References 28 publications

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“…Intravascular midazolam can reach the placenta and induce a decrease in the Apgar score, whereas intrathecal midazolam produces an inconsequential plasma midazolam level that does not decrease the Apgar score, as reported previously [22]. …”

Section: Discussionsupporting

confidence: 73%

Reduction in labor pain by intrathecal midazolam as an adjunct to sufentanil

Salimi¹,

Nejad²,

Safari³

et al. 2014

Korean J Anesthesiol

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BackgroundAnesthesia today has strived to decrease labor pain in a tolerable and controllable fashion. Intrathecal midazolam has been introduced as an adjunct to analgesics. The study was planned to assess the efficacy, safety and duration of analgesia produced by intrathecal midazolam adjunct to sufentanil in decreasing labor pain.MethodsIn a randomized clinical trial 80 parturient included in the study. The two groups were matched for age, cervical dilation, gravid, gestational age, and other demographic characteristics. Combination of sufentanil and midazolam administered intrathecally to experimental group and compared to sufentanil group. Time to reach maximum block, and pain score was measured and recorded.ResultsGroups were matched for age and weight and other demographic characteristic. No significant adverse effect was seen in both groups including decrease in Apgar score. Duration of analgesia was 92.0 ± 12.7 in sufentanil group and 185.2 ± 15.2 minutes in midazolam and sufentanil group which was significantly different (P = 0.002). Numeric rating scale score was significantly lower in midazolam group compare to sufentanil group at 120 min (P = 0.01), 150 min (P = 0.0014), and 180 min (P = 0.001).ConclusionsIntrathecal midazolam as an adjunct to opioid could significantly enhance analgesia in labor pain with no significant adverse effect. Intrathecal injection of midazolam is an appropriate alternative to parenteral or epidural analgesia in small hospital settings.

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Section: Discussionsupporting

confidence: 73%

Reduction in labor pain by intrathecal midazolam as an adjunct to sufentanil

Salimi¹,

Nejad²,

Safari³

et al. 2014

Korean J Anesthesiol

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“…Benzodiazepinlerin plasentaya geçerek neonatal depresyona neden olabileceği endişesi ile gebelerde anksiyolitik maksatlı kullanımından günlük uygu-lamada kaçınılsa da sedasyon dozunda (<0,025 mg.kg -1 ) midazolam uygulamasının bebek üzerinde herhangi bir solunum depresyonuna ve kötüleşmiş APGAR skoruna neden olmadığı gösterilmiştir. 16,17 İnhalasyon anestezisi ile indüksiyon; yavaş başlangıçlı olması, neonatal depresyona neden olması, miyokardiyal depresyon yapması gibi nedenlerden ötürü tercih edilmemiştir. Olgunun gebe ve morbid obez olması, artmış aspirasyon riskini beraberinde getirdiğinden, indüksiyon süresini kısa tutmak amaçlanmıştır.…”

Section: Discussionunclassified

Anaesthetic Management for Caesarean Section in a Patient with Severe Pulmonary Stenosis

Kumcu¹,

Hayran²,

Erbüyün³

2018

Turkiye Klinikleri J Anest Reanim

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onjenital veya edinsel kalp kapak hastalığı bulunan gebelerin izlemi ve doğum stratejilerinin uygun şekilde yönetilmesi hekimler için önem arz eden bir konudur. Sezaryen ameliyatı için uygulanan çeşitli anestezi yöntemleri hastanın kardiyak durumuna bağlı olarak farklı hemodinamik yanıtlara neden olmaktadır. Çoğunlukla çocukluk çağında tanı alıp, tedavi edilse de tanı almamış pulmoner darlık vakaları erişkin çağlarda görülebilmektedir ve bu hastalarda detaylı tetkik ve gözleme gerek duyulmaktadır. Pulmoner darlık, erişkinlerde görülen konjenital kalp hastalıklarının yaklaşık %10-12'sini oluşturmaktadır. 1 Sık görülmemesi sebebiyle ciddi pulmoner darlığı olan hastalarda önerilen standart bir anestezi yöne

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“…Many published studies had used different opioids like alfentanil,[19] fentanyl,[20] and remi fentanyl[21] before induction of anesthesia for elective cesarean section. The result of these studies is as follows: In alfentanil study, alfentanil 10 μg/kg was given 1 minute before induction of anesthesia; and maternal stress response was attenuated in the alfentanil group but at the cost of early neonatal depression.…”

Section: Discussionmentioning

confidence: 99%

Maternal and neonatal effects of nalbuphine given immediately before induction of general anesthesia for elective cesarean section

et al. 2011

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Background:Although nalbuphine was studied extensively in labour analgesia and was proved to be acceptable analgesics during delivery, its use as premedication before induction of general anesthesia for cesarean section is not studied. The aim of this study was to evaluate the effect of nalbuphine given before induction of general anesthesia for cesarean section on quality of general anesthesia, maternal stress response, and neonatal outcome.Methods:Sixty full term pregnant women scheduled for elective cesarean section, randomly classified into two equal groups, group N received nalbuphine 0.2 mg/kg diluted in 10 ml of normal saline (n=30), and group C placebo (n=30) received 10 ml of normal saline 1 min before the induction of general anesthesia. Maternal heart rate and blood pressure were measured before, after induction, during surgery, and after recovery. Neonates were assisted by using APGAR0 scores, time to sustained respiration, and umbilical cord blood gas analysis.Result:Maternal heart rate showed significant increase in control group than nalbuphine group after intubation (88.2±4.47 versus 80.1±4.23, P<0.0001) and during surgery till delivery of baby (90.8±2.39 versus 82.6±2.60, P<0.0001) and no significant changes between both groups after delivery. MABP increased in control group than nalbuphine group after intubation (100.55±6.29 versus 88.75±6.09, P<0.0001) and during surgery till delivery of baby (98.50±2.01 versus 90.50±2.01, P<0.0001) and no significant changes between both groups after delivery. APGAR score was significantly low at one minute in nalbuphine group than control group (6.75±2.3, 8.5±0.74, respectively, P=0.0002) (27% of nalbuphine group APGAR score ranged between 4–6, while 7% in control group APGAR score ranged between 4–6 at one minute). All neonates at five minutes showed APGAR score ranged between 9–10. Time to sustained respiration was significantly longer in nalbuphine group than control group (81.8±51.4 versus 34.9±26.2 seconds, P<0.0001). The umbilical cord blood gas was comparable in both groups. None of the neonates need opioid antagonist (naloxone) or endotracheal intubation.Conclusion:Administration of nalbuphine before cesarean section under general anesthesia reduces maternal stress response related to intubation and surgery, but decreases the APGAR score at one minute after delivery. So, when nalbuphine was used, all measures for neonatal monitoring and resuscitation must be available including attendance of a pediatrician.

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A single dose of fentanyl and midazolam prior to Cesarean section have no adverse neontal effects

Abstract: Maternal analgesia and sedation with fentanyl (1 microg x kg(-1)) and midazolam (0.02 mg x kg(-1)) immediately prior to spinal anesthesia is not associated with adverse neonatal effects.

Cited by 51 publications

References 28 publications

Reduction in labor pain by intrathecal midazolam as an adjunct to sufentanil

Reduction in labor pain by intrathecal midazolam as an adjunct to sufentanil

Anaesthetic Management for Caesarean Section in a Patient with Severe Pulmonary Stenosis

Maternal and neonatal effects of nalbuphine given immediately before induction of general anesthesia for elective cesarean section

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