Effects of intravenous midazolam during spinal anaesthesia for caesarian section

Deka, Bipul Prasad; Talukdar, Bharat; Laha, Amal Kumar; Borah, Susmita

doi:10.18203/2319-2003.ijbcp20161514

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Midazolam related antiemetic effect may be attributed to reducing synthesis, release, and postsynaptic effect of dopamine by acting on CRTZ-mediated regions. 7,23 Parturients who are awake during surgery may suffer anxiety, fear, and stress, and a certain degree of sedation can increase the patient satisfaction and affect PONV. 24 In the present study, patient satisfaction was significantly higher in group D and group M, in which patients experienced a higher degree of sedation and a lower incidence of PONV, compared with group C. Although there was no significant difference in the incidence of PONV between the group D and group M, the patient satisfaction in group D was higher compared with group M, which may be related to the fact that the number of PONV and other adverse reactions (such as flushing and chest distress) in group D was less than that in group M.…”

Section: Discussionmentioning

confidence: 99%

<p>A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial</p>

Hu¹,

Zhou²,

Zou³

et al. 2020

DDDT

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To compare the efficacy of dexmedetomidine and midazolam in the prevention of postoperative nausea and vomiting (PONV) caused by hemabate in postpartum hemorrhage during cesarean delivery. Methods: One hundred and five parturients with American Society of Anesthesiology (ASA) physical status I and II, aged 20-40 years, undergoing elective cesarean delivery under epidural anesthesia were randomly allocated into dexmedetomidine group (group D, n=35), midazolam group (group M, n=35) and control group (group C, n=35). Patients received an intrauterine injection of 250 μg hemabate and continuous intravenous infusion of 5 units oxytocin immediately following the delivery of the infant. At the same time, patients in group D received 1μg/kg intravenous dexmedetomidine, group M received 0.02 mg/kg intravenous midazolam and group C received 20 mL intravenous saline. Parameters such as the PONV, other adverse reactions (chest distress, flush, etc.) caused by hemabate, patient satisfaction, the sedation (OAA/S) scores, and the hemodynamic parameters were recorded in both groups. Results: The PONV incidence in group D and group M was significantly lower compared with group C (6%, 17%, and 71% for group D, group M, and group C, respectively, P<0.05). The sedation (OAA/S) scores in group D and group M was significantly higher compared with group C (1.62±0.28, 1.75±0.31, and 1.00±0.00 for group D, group M, and group C, respectively, P<0.05). The patient satisfaction in group D and group M was significantly higher compared with group C (94%, 69%, and 46% for group D, group M, and group C, respectively, P<0.05). Furthermore, there were more patients satisfied with group D than group M (94% vs.69%, P<0.05). Conclusion: Intravenous dexmedetomidine (1 μg/kg) and midazolam (0.02 mg/kg) were equally effective in preventing PONV introduced by hemabate and dexmedetomidine is superior to midazolam in patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

<p>A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial</p>

Hu¹,

Zhou²,

Zou³

et al. 2020

DDDT

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“…Spinal anesthesia (SA) recently has gained popularity for cesarean section due to the change of attitude secondary to an increased awareness for the safety of regional block for both mother and newborns [ [1] , [2] , [3] , [4] ]. The extremely small dose of local anesthetic used nearly eliminates the possibility of a systemic toxic reaction and will not cross the placenta to any appreciable degree compared with epidural anesthesia [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Magnitude and associated factors of intraoperative nausea and vomiting among parturients who gave birth with cesarean section under spinal anesthesia at South Gondar zone Hospitals, Ethiopia

Chekol

Zewudu

Eshetie

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Intraoperative nausea and vomiting are common intraoperative events by which parturient feel discomfort and disturbed after spinal anesthesia. Methods Hospital-based cross-sectional study was conducted on mothers who underwent cesarean section with spinal anesthesia. Descriptive analysis and chi-square test were employed. Bivariable and multivariable logistic regressions were used to measure the association of factors with the outcome variable intraoperative nausea and vomiting. A p-value of ≤0.05 was used to decide statistical significance for multivariable logistic regression. Result A total of 246 parturients were participated in this study. The incidence of intraoperative nausea and vomiting was 40.2%. According to multivariable logistic regression, age greater than 30 years (AOR, 6.26; 95%CI, 2.2–17.78; p-value 0.001), primiparous (AOR, 3.72; 95%CI, 1.35–10.24; p-value, 0.011), having motion sickness (AOR, 7.1; 95%CI, 2.75–18.33; p-value 0.001), emergency cesarean sectin (AOR, 9.85; 95%CI, 3.19–30.38; p-value 0.001), oxygen suplimentation (AOR, 0.021; 95%CI, 0.005–0.08; p-value 0.0001) and uterotonic agent (AOR, 2.99; 95%CI 1.24–7.22; p-value 0.015) had statistically significant association with intraoperative nausea and vomiting. Conclusion In our study, the overall incidence of intraoperative nausea and vomiting after spinal anesthesia was 40.2%. Parturients with age greater than 30 years, having motion sickness, didn't get intraoperative supplemental oxygen, oxytocin used for the uterotonic purpose, emergency surgery, and primiparous were at increased risk of intraoperative nausea and vomiting.

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Sedative effect of propofol and midazolam in surgery under spinal anaesthesia: A comparative study

Patel¹,

Maliwad²,

Mehta³

et al. 2020

IJCA

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Intravenous medications are invariably required to allay anxiety related to surgical procedures, in patients undergoing surgery under regional anesthesia. A thorough pre anaesthetic check up and details of the surgical procedure planned are necessary before administration of sedative agents to attain desirable levels of sedation and avoid unwanted adverse events. To observe, record and analyse sedative effect of intravenous Propofol and Midazolam in lower extremities and lower abdominal surgery scheduled under regional anesthesia techniques.: A single blinded comparative study conducted in tertiary care hospital of Gujarat. Sixty patients with no organic pathology & a moderate but definite systemic disturbance categorized into two groups labeled as propofol group (n=30) and Midazolam group (n=30) of either gender and shortlisted for surgery using subarachnoid block. Observer’s Assessment of Alertness/Sedation Scale (OAA/S Scale) and Ramsay sedation scale was used to assess effective sedation.: Basic patients characteristics, Mean age (SD) was 31.57 + 10.57 years in category I (P group) and 35.33 + 9.98 years in category II (M group) was comparable between the groups. In category I 16(53.3%) patients reached targeted sedation level in < 60 seconds, in group M 18 (60%) patients required 90-120 seconds to achieved the same level of sedation (p<0.001). Propofol gives rapid onset of sedation and faster recovery, while midazolam provides more hemodynamic stability in regional anesthesia.

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Effects of intravenous midazolam during spinal anaesthesia for caesarian section

Cited by 3 publications

References 11 publications

<p>A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial</p>

<p>A Comparison of Dexmedetomidine and Midazolam for the Prevention of Postoperative Nausea and Vomiting Caused by Hemabate in Cesarean Delivery: A Randomized Controlled Trial</p>

Magnitude and associated factors of intraoperative nausea and vomiting among parturients who gave birth with cesarean section under spinal anesthesia at South Gondar zone Hospitals, Ethiopia

Sedative effect of propofol and midazolam in surgery under spinal anaesthesia: A comparative study

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