The effects of midazolam and fentanyl on neonates in elective cesarean section

Abstract

Aim: As in all patients scheduled for surgery, obstetric patients may have both surgery and operating room fear, and secondary autonomic stress response may develop. To compare the effects of premedication with fentanyl or midazolam on maternal anxiety, tolerance of the birthing process. and central nervous system depression of the newborn.

Material and Methods: ASA II patients scheduled for elective cesarean section with spinal anesthesia who gave informed consent were randomized into two groups to receive either 0.025 mg/kg iv midazolam or 1 mcg/kg iv fentanyl. The APAIS score was recorded before and five minutes after premedication. Following the delivery of the newborn, the APGAR score was recorded at the first and fifth minutes, and the NACS score was recorded at the fifteenth minute. The primary outcome was a decrease in APAIS scores, the secondary outcomes were differences in APGAR and NACS scores.

Results: Data of 50 patients were analyzed. First-minute APAIS score was similar (19.3 +/- 5.3 vs 19.6 +/- 4.7, p-0.82), but the decrease at the fifth minute was more prominent in the midazolam group (10.8 +/- 3.8 vs 15.3 +/- 4.9, p=0.001). APGAR and NACS scores were similar (p-0.87, p=0.58, and p=0.65, respectively).

Discussion: This study found that midazolam was more effective in reducing anxiety in uncomplicated pregnant patients with no apparent postdelivery depression in the newborn.