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- W2321851018 abstract "Cree et al. found that a total maternal dose of up to 30 mg diazepam in the 15 h before delivery had little in the way of adverse neonatal effects [1]. Whitelaw et al. subsequently drew attention to the need for intensive care support for preterm neonates whose severely pre-eclamptic mothers had received lorazepam by continuous intravenous infusion [2]. Both these references are of questionable relevance to the issue of my administration of midazolam 4 mg (0.05 mg.kg−1) to a very anxious woman with severe pre-eclampsia and recent subarachnoid haemorrhage who was about to undergo urgent Caesarean section. Midazolam at the considerably larger doses of 0.2 mg.kg−1 and 0.3 mg.kg−1 has been compared with thiopental at induction of anaesthesia for Caesarean section. One study found poorer Apgar scores among neonates whose mothers received midazolam, although there were no differences in neurobehavioural scores at 4 h [3]. In the other study, Apgar scores were similar, but neonatal body temperature, arm recoil and general body tone were slightly reduced within the first 2 h after delivery in the midazolam group [4]. However, both studies concluded that midazolam was an acceptable alternative to thiopental. I ensured that a premature neonate carried by a pre-eclamptic mother would be delivered into the hands of a paediatrician prepared to provide immediate respiratory support and subsequent intensive care. Although I warned only of the opioid component of the induction sequence, I could indeed have specified that a benzodiazepine would be used, and might equally have explained that an unusually generous dose of thiopental (6.25 mg.kg−1) would form the basis of this neuroanaesthetic induction. However, I suspect that the neonatal consequences of the maternal administration of midazolam 0.05 mg.kg−1 were trivial, and stress that I gave midazolam as an adjunct to, not a substitute for, local anaesthesia." @default.
- W2321851018 created "2016-06-24" @default.
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- W2321851018 date "2000-02-01" @default.
- W2321851018 modified "2023-09-26" @default.
- W2321851018 title "A reply" @default.
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- W2321851018 cites W2015183724 @default.
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- W2321851018 doi "https://doi.org/10.1046/j.1365-2044.2000.1298b.x" @default.
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