The sedative effect of intravenous injection of low dose midazolam during spinal anesthesia in cesarean section.

B K Fung, A J Gislefoss, E S Ho
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Abstract

In a randomized blind study, we compared the neonate Apgar score, umbilical venous pH, incidence of maternal hypotension and intra-operative maternal discomfort in elective Cesarean section performed under spinal anesthesia in two groups of parturients with or without low dose midazolam as a sedative agent before the deliveries. Each group consisted of 20 parturients. Ninety percent of the mothers in the midazolam group fell asleep smoothly before the operations started. The neonates in the midazolam group were scored similar to saline control group on Apgar score and umbilical venous pH. The incidences of maternal hypotension during operation in both groups were 55%. However, the occurrence of intra-operative maternal discomfort was eleven fold more often in the saline control group. On the other hand, there existed a significant inverse correlation between uterine incision-delivery interval and Apgar score as well as umbilical venous pH. We concluded that low dose midazolam is a good sedative agent during spinal anesthesia in elective Cesarean section. It is also safe and effective even given before delivery.

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剖宫产术腰麻时静脉注射小剂量咪达唑仑的镇静作用。
在一项随机盲法研究中,我们比较了两组在脊髓麻醉下择期剖宫产术中使用或不使用低剂量咪达唑仑的新生儿Apgar评分、脐静脉pH值、产妇低血压发生率和产妇术中不适。每组20例产妇。咪达唑仑组90%的母亲在手术开始前顺利入睡。咪达唑仑组新生儿Apgar评分及脐静脉ph值与生理盐水对照组相近,两组术中产妇低血压发生率均为55%。然而,术中产妇不适的发生率是生理盐水对照组的11倍。另一方面,剖宫产间隔与Apgar评分及脐静脉ph呈显著负相关。我们认为,低剂量咪达唑仑是择期剖宫产腰麻时较好的镇静药物。即使在分娩前服用也是安全有效的。
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