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A Randomized Comparison Between Midazolam and Thiopental for Elective Cesarean Section Anesthesia

I. Mothers

Department of Anesthesiology, Esbjerg Central Hospital, Esbjerg, and the *Department of International Clinical Research, Roche A/S, Hvidovre, Denmark.

Abstract

In a randomized blind trial midazolam (0.3 mg kg^–1) was compared with thiopental (4 mg kg^–1), both combined with meperidine-nitrous oxide, for elective cesarean section anesthesia in 40 women. We found no statistically significant differences between thiopental and midazolam at induction, during operation or recovery with regard to maintenance doses, change in maternal neurologic status based on a modified Glasgow Coma Scale, systolic blood pressure, and heart rate. Induction time was 120 seconds with midazolam and 111 seconds with thiopental. There were significant differences with regard to diastolic blood pressure. Side effects occurred with approximately equal frequencies, but vomiting was significantly more frequent after thiopental. Perivenous tenderness and erythema occurred in four patients, all after thiopental. Midazolam appears to be a suitable alternative to thiopental for the induction and maintenance of anesthesia for elective cesarean section.

Key Words: ANESTHESIA, obstetric • ANESTHETICS, INTRAVENOUS—thiopental, midazolam • HYPNOTICS, BENZODIAZEPINES— midazolam