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. 2016 Sep-Dec;10(3):631-636.
doi: 10.4103/0259-1162.191117.

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

Ali M Mokhtar  1 , Ahmed I Elsakka  1 , Hassan M Ali  1
Affiliations

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

Ali M Mokhtar et al. Anesth Essays Res. 2016 Sep-Dec.

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.

Keywords: Anxiety; cesarean delivery; midazolam; preeclampsia.

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Figures

Figure 1
Figure 1
Amsterdam Preoperative Anxiety and Information Scale
See this image and copyright information in PMC

References

    1. Gogarten W. Preeclampsia and anaesthesia. Curr Opin Anaesthesiol. 2009;22:347–51. - PubMed
    1. Wallace DH, Leveno KJ, Cunningham FG, Giesecke AH, Shearer VE, Sidawi JE. Randomized comparison of general and regional anesthesia for cesarean delivery in pregnancies complicated by severe preeclampsia. Obstet Gynecol. 1995;86:193–9. - PubMed
    1. Karinen J, Räsänen J, Alahuhta S, Jouppila R, Jouppila P. Maternal and uteroplacental haemodynamic state in pre-eclamptic patients during spinal anaesthesia for Caesarean section. Br J Anaesth. 1996;76:616–20. - PubMed
    1. Hood DD, Curry R. Spinal versus epidural anesthesia for cesarean section in severely preeclamptic patients. A retrospective survey. J Am Soc Anesthesiol. 1999;90:1276–82. - PubMed
    1. Henke VG, Bateman BT, Leffert LR. Focused review: Spinal anesthesia in severe preeclampsia. Anesth Analg. 2013;117:686–93. - PubMed