Influences of Different Doses of Midazolam on Mother and Fetus in Fetoscopic Surgery for Twin-to-Twin Transfusion Syndrome

Abstract

Objective: We observed influences of different doses of intravenous midazolam on mother and fetus in fetoscopic surgery for twin-to-twin transfusion syndrome (TTTS). Methods: A total of 18 pregnant women with TTTS were randomly divided into groups M1 and M2 according to differing doses of midazolam. Some parameters were respectively recorded as prior to administration of midazolam (T0), instantly after anesthesia induction (T1), at incision (T2), instantly after laser coagulation (T3) and at the end of surgery (T4). Results: There was no statistical difference in oxygen saturation and respiratory rate between groups M1 and M2 (all p > 0.05); but mean arterial pressure, heart rate, anxiety visual analog test, Observer's Assessment of Alertness/Sedation scale values and Kreb's scores were significantly lower in group M2 than in group M1 from T1 to T4 (all p < 0.05). In both groups, there was no fetal movement during laser coagulation. Conclusion: We propose that the appropriate dose for midazolam be 0.02 mg/kg in fetoscopic surgery for TTTS.

Evaluation and Treatment of Pain in Fetuses, Neonates and Children

“…Most authors use deep general maternal anesthesia in ex-utero intrapartum therapy surgery to anesthetic the mother and the fetus and in fetoscopies the preferences are administrate the anesthesia and analgesia directly to the fetus, usually applying an intramuscular route or umbilical line [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”