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

Abstract

Background:Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery.Methods:A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia. Maternal anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS); postoperative maternal satisfaction was assessed using Maternal Satisfaction Scale for Cesarean Section (MSSCS). Newborns were assessed using Apgar score, Neonatal Neurologic and Adaptive Capacity Score (NACS), and umbilical artery blood gases.Results:Mothers premedicated with midazolam showed a lower level of preoperative anxiety and a higher degree of postoperative satisfaction than the control group. There were no between-group differences regarding the neonatal outcome.Conclusion:Preeclamptic parturients premedicated with midazolam (0.035 mg/kg) before spinal anesthesia have lower anxiety and higher postoperative satisfaction levels, with no adverse effects on the newborns.

Frecuencia de ansiedad preoperatoria y factores asociados en gestantes programadas a cesárea

“…Mientras que en nuestro estudio se encontró una puntuación media de la subescala de ansiedad de 7,38 ± 3,45. En una evaluación realizada en Egipto (21) , también con escala APAIS en mujeres con preeclampsia, encontraron una puntuación superior, no informaron sobre la frecuencia de la AP e indicaron que realizar premedicación con midazolam permitía reducir la puntuación del APAIS de 17,1 ± 3,1, antes de pasar la paciente a la sala de cirugía, al 11,9 ± 1,9 a los cinco minutos de aplicada la premedicación. Detectar la AP obliga a realizar un seguimiento e intervención terapéutica.…”

Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report

“…14 A single dose of midazolam or fentanyl before caesarean delivery can lower the patient’s anxiety and have no adverse neonatal effects. 15,16 Even listening to music before surgery may be helpful for reducing stress-related physiological reactions. 17 Careful consideration for the patients’ anxiety is required in patients under regional anaesthesia compared with those under general anaesthesia.…”

Low-dose midazolam for anxiolysis for pregnant women undergoing cesarean delivery: a randomized trial

“…A significance level of 5% was chosen. Sample size was calculated based on previous studies 15 , 23 , 24 , 25 and by repeated analysis of the hypothesis tests performed during data collection. Calculations were performed using the Statistical Analysis System software for Windows (SAS Institute Inc. Cary, NC, USA – version 9.4) and Minitab Statistical Software (version 16).…”