title: Premedication with midazolam prior to cesarean delivery in preeclamptic parturients: A randomized controlled trial.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesia, Cairo University, Cairo, Egypt.
authors.forename: Ali M
authors.initials: AM
authors.lastname: Mokhtar
authors.affiliation: Department of Anesthesia, Cairo University, Cairo, Egypt.
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Elsakka
authors.affiliation: Department of Anesthesia, Cairo University, Cairo, Egypt.
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Ali
keywords: Anxiety; cesarean delivery; midazolam; preeclampsia