Comparative Evaluation of Intravenous Propofol and Midazolam on Sedation and Nausea & Vomiting During Spinal Anesthesia in Cesarean Section

Anxiety can affect the outcome of spinal anesthesia in cesarean section. Therefore, it is necessary to reduce the amount by using a suitable drug with few complications. The aim of the present study was to compare and evaluate the intravenous Propofol and Midazolam on sedation and nausea and vomiting during spinal anesthesia in cesarean section.

The present clinical trial study was conducted at Fatemieh Hospital in Hamadan, Iran, in 2020. One-hundred and two candidates underwent cesarean section under spinal anesthesia randomly in two groups of 51 intravenously injecting propofol (0.2 mg/kg) or midazolam (0.02 mg/kg) after weaning. Demographic and obstetric data, hemodynamic status, sedation score (Ramsey), time of onset of sedation and duration of sedation, nausea, and vomiting were compared in the two groups in the first hour after drug injection. The collected data were analyzed using chi-square, t-test and Mann-Whitney statistical tests.

The onset of sedation (4.72 ±0.60 vs. 1.43 ±60 min) and the duration of sedation (55.00± 6.92 vs. 44.60 ±7.13 min) were less in the propofol group than in the midazolam group (For both outcomes (p =0.001). Mean Visual Analogue Scale (VAS) of anxiety after drug administration up to 5 minutes with a significant difference in the propofol group less than both groups had similar conditions. Mean sedation score after drug administration up to 10 minutes in the group) Propofol was higher in the midazolam group from 50 to 60 minutes, with a prevalence of nausea and vomiting during surgery in the midazolam group of 5.9% and in the propofol group of 2% (p = 0.217). Hypotension in the midazolam group was 3.9%. In addition, the propofol group was 19.6% (p = 0.028). The frequency of tachycardia, bradycardia, headache, chills, and recollection showed no significant difference between the two groups. Injection of the drug up to 10 minutes was significantly higher than the propofol group (P = <0.05).

Propofol is effective due to its sedative effect, reduction of anxiety and nausea and vomiting in cesarean section patients under anesthesia. However, due to hypotension, it is better to take the necessary preventive precautions.