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Midazolam may induce immediate retrograde amnesia during Cesarean delivery
Abstract Number: S-25
Abstract Type: Original Research
Background: The aim of this study was to determine the effects of midazolam on retrograde amnesia during Cesarean delivery.
Methods: This study was designed as a prospective, case-control study on parturients undergoing Cesarean delivery during spinal anesthesia. Patients were divided into two groups; midazolam group and control group. Analysis of retrograde amnesia was performed with a card recall test, where 7 picture cards were shown after the birth of the baby in 1 minute intervals. Patients in the midazolam group received midazolam (0.1mg/kg IV), 1 minute after the 6th card was shown, whereas patients in the control group did not receive any injection. Objects in the cards were recalled 30 minutes after the operation using open questions and the number of correct objects recalled was recorded. Statistical analysis was done using Mann-Whitney test and Fisher’s exact test.
Results: A total of 52 patients participated in this study; 27 in midazolam group and 25 in control group. Results of individual card recalls at respective time points between the two groups did not differ significantly, with the exception of the 7th card shown after midazolam administration; 19 patients of the control group recalled the 7th card, whereas none of the patients in the midazolam group recalled the 7th card (OR 165, 95% CI 8.766-3105.9, p<0.0001). After dichotomization of the cards into first 3 cards, and latter 3 cards before injection, however, significant decreased recall of the latter 3 cards was observed in midazolam group compared to control group (OR 2.48, 95%CI 1.205-5.105, p=0.0143). Within the midazolam group, when compared to the 1st card, the recall rates of 4th, 5th and 6th were significantly decreased (Fig. 1).
Conclusions: The present study suggests that midazolam may induce immediate retrograde amnesia (<3minutes). Decreased or impossible communication should be considered in exchanging important information with patients, especially the period immediately prior to midazolam administration.
Ref. Bulach R, Myles PS, Russnak M. Double-blind randomized controlled trial to determine extent of amnesia with midazolam given immediately before general anaesthesia.Br J Anaesth. 2005 Mar;94(3):300-5