Nazar, M., Salman, I. (2024). Using midazolam and propofol as a sedation during spinal anesthesia in elective cesarean section.. , 23(4), 494-499. doi: 10.52573/ipmj.2025.141727
Mohammed Nazar; Iyad Abbas Salman. "Using midazolam and propofol as a sedation during spinal anesthesia in elective cesarean section.". , 23, 4, 2024, 494-499. doi: 10.52573/ipmj.2025.141727
Nazar, M., Salman, I. (2024). 'Using midazolam and propofol as a sedation during spinal anesthesia in elective cesarean section.', , 23(4), pp. 494-499. doi: 10.52573/ipmj.2025.141727
Nazar, M., Salman, I. Using midazolam and propofol as a sedation during spinal anesthesia in elective cesarean section.. , 2024; 23(4): 494-499. doi: 10.52573/ipmj.2025.141727

Using midazolam and propofol as a sedation during spinal anesthesia in elective cesarean section.

Iraqi Postgraduate Medical Journal
Article 19, Volume 23, Issue 4, October 2024, Pages 494-499    PDF (226.79 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2025.141727
Authors
Mohammed Nazar* 1; Iyad Abbas Salman2
1Department of anasthesia, mousel ,Iraq
2The Iraqi Board for Medical Specialization, Baghdad, Iraq
Abstract
Abstract
Background
The most typical setting for performing an elective cesarean section is under spinal anesthesia. To lessen the patients' dread and foster greater acceptance, a sleeping dose of anesthetic medication (propofol or midazolam) is necessary.

Objective
The ability of a sleep-inducing dose of propofol or midazolam to increase pregnant women undergoing elective c/s under spinal anesthesia's acceptance of regional anesthetic

Patients and method
75 American Society of Anesthesiologists (ASA) physical status II pregnant ladies undergoing elective C/S under spinal anesthesia (bupivacaine 12mg 0,5%) and after clamping the umbilical cord, we gave normal saline immediately for the first group (IV 1 ml, n = 25, which is considered group A), the second group received propofol (bolus 1 mg/kg, n = 25, which is considered group B), and the third group received midazolam (bolus 1–2 mg, n = 25, which is considered group C)
And we recorded the Ramsey score, blood pressure, pulse rates, nausea, and vomiting.

Results:
We found a significant difference in the p-value in the modified Ramsay score in the 1st minute (group A was 1.5±0,8), group B was 4,0 ± 1,01, and group C was 4.5 ± 1,08). In the 15th minute, (group A was 1± 2,1), (group B was 3 ± 0,7), and (group C was 3.5 ± 1,04).

Conclusion:
The study shows that using a sleeping dose of propofol or midazolam will improve the patient's well-being and increase the acceptance of regional anesthesia. And there are no significant hemodynamic
Keywords
midazolam,,; ,،Ramsay score,,; ,،bupivacaine,,; ,،spinal anesthesia.,,; ,،Propofol
References
  1. Miller RD, Cucchiara RF Anesthesia, 5th ed. Philadelphia: Churchill Livingstone, USA. 2000:1512-20.
  2. Moller RD, Eriksson LI, Fleischer LA, Wiener-Kronish JP, Young WL Miller’s Anesthesia, 6th ed. Philadelphia: Churchill Livingstone, USA. 2010:2046- 58.
  3. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesthesia & Analgesia. 2006 ;102:1884-98.
  4. Borgeat A, Ekatodramis G, Schenker CA. Postopera1ve Nausea and Vomi1ng in Regional AnesthesiaA Review. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2003;98:530-47.
  5. Garcia-Miguel FJ, Montano E, Marcn-Vicente V, Fuentes AL, Alsina FJ, San Jose JA. Prophylaxis against intraopera1ve nausea and vomi1ng during spinal anesthesia for cesarean sec1on: a compara1ve study of ondansetron versus metoclopramide. The Internet Journal of Anesthesiology. 2000;4.
  6. American Society of Anesthesiologists Task Force on Seda1on and Analgesia by Non-Anesthesiologists. Prac1ce guidelines for seda1on and analgesia by non-anesthesiologists. Anesthesiology 2002;96:1004-17.
  7. Fujii Y, Numazaki M. Dose-range effects of propofol for reducing eme1c symptoms during cesarean delivery. Obstetrics & Gynecology. 2002;99:75-79.
  8. Groike O, Müller J, Dietrich PJ, Krause TH, Wappler F. Comparison of premedica1on with clonidine and midazolam combined with TCI for orthopedic shoulder surgery. Anasthesiol Intensivmed Notfallmed Schmerzther. 2003;38:772-80.
  9. Isik G, Gunes Y, Guler T, Unlugenc H. Comparative study of the antiemetic efficacy of propofol and midazolam in the early postoperative period. Eur J Anaesthesiol. 2003;20:668-73.
  10. Flaherty JE, Ramirez AM, Dom PM, Bauer KP. Preoperative intravenous midazolam: patient satisfaction and other perioperative outcomes. ASA Annual Meeting Abstracts. 2002;97:A32.
  11. Metz A, Hebbard G. Nausea and vomiting in adults: a diagnostic approach. Aust Fam Physician. 2007;36:733-37.
  12. Tintinalli JE. Emergency Medicine: A Comprehensive Study Guide. New York: McGraw-Hill; 2010. p. 830.
  13. Zubieta-Calleja GR, Paulev PE, Zubieta-Calleja L, Zubieta-Calleja N, Zubieta-Castillo G. Hypoventilation in chronic mountain sickness: a mechanism to preserve energy. J Physiol Pharmacol. 2006;57:425-30.
  14. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32:260-7.
  15. Corning JL. N.Y. Med J. 1885;42:483. Reprinted in: Classical File, Survey of Anesthesiology. 1960;4:332.
  16. Cravero JP, Kaplan RF, Landrigan-Ossar M, Coté CJ. Sedation for diagnostic and therapeutic procedures outside the operating room. In: A Practice of Anesthesia for Infants and Children. 6th ed. Philadelphia: Elsevier2019. p. 1109-28.
  17. Colon EA, Popkin MK. Anxiety and panic. In: Rundell JR, Wise MG, editors. The American Psychiatric Press Textbook of Consultation-Liaison Psychiatry. Washington DC: American Psychiatric Press Inc; 1996. p. 402-25.
  18. Meyers CJ, Eisig SB, Kraut RA. Comparison of propofol and methohexital for deep sedation. J Oral Maxillofac Surg. 1994;52:449-52. doi:10.1016/0278-2391(94)90337-9.
  19. Tucker MR, Ochs MW, White RP. Arterial blood gas levels after midazolam or diazepam administered with or without fentanyl as an intravenous sedative for outpatient surgical procedures. J Oral Maxillofac Surg. 1986;44:688-92.
  20. Dembo JB. Methohexital versus propofol for outpatient anesthesia part II. J Oral Maxillofac Surg. 1995;53:816-20. doi:10.1016/0278-2391(95)90340-2.
  21. Rodrigo C, Chow KC. A comparison of 1- and 3-minute lockout periods during patient-controlled sedation with midazolam. J Oral Maxillofac Surg. 1995;53:406-8. doi:10.1016/0278-2391(95)90712-2.
  22. Parworth LP, Frost DE, Zuniga JR, Bennet T. Propofol and fentanyl compared with midazolam and fentanyl during third molar surgery. J Oral Maxillofac Surg. 1998;56:447-53. doi:10.1016/S0278-2391(98)90710-8.
  23. Tarhan O, Canbay O, Celebi N, Uzun S, Sahin A, Coskun F, Aypar U. Subhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for cesarean section. Minerva Anestesiol. 2007;73:629-33.
  24. Shahriari A, Khooshideh M, Heidari MH. Prevention of nausea and vomiting in cesarean section under spinal anesthesia with midazolam or metoclopramide. J Pak Med Assoc. 2009;59:756-9.
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