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

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.