Abstract Introduction: Anxiety and fear are common among pregnant women undergoing cesarean delivery. In addition to psychologically unpleasant, they can elicit endocrine and metabolic changes. Administration of benzodiazepines in this patient group is uncommon and investigation focusing on the topic is rare. This study aimed to determine anxiolysis efficacy of low-dose midazolam administered preoperatively, right before cesarean delivery, and to evaluate whether its administration impacts neonatal vitality, maternal consciousness, and recall of the moment the baby was born. Method: Fifty pregnant women with indication for cesarean delivery were included in this randomized, double-blind, placebo-controlled clinical study and allocated into two groups of 25 participants each (Midazolam and Control group). Midazolam (0.0125 mg.kg-1) or a placebo solution was administered immediately before spinal anesthesia and the anxiolytic effect was assessed using a visual analogue scale before and after administration. We registered the Apgar score at 1 and 5 minutes, the Ramsay scale and recall of the moment of birth, that was assessed 90 minutes after birth. Results: Pregnant women from the Midazolam group presented a 1.3-point reduction in anxiety on the visual analogue scale, while the Control group showed virtually no change (p = 0.027). We observed no statistically significant changes in Apgar scores, level of maternal consciousness and recall of the moment of delivery. Conclusions: Low-dose midazolam can provide anxiety management in pregnant women undergoing cesarean delivery with no significant undesirable effects.

Abstract Background: Lung diseases and different forms of breathing may interfere with cardiac autonomic modulation (CAM). Objective: To compare CAM in individuals with chronic obstructive pulmonary disease (COPD) with healthy individuals during spontaneous breathing (SB) and controlled breathing (CB). Methods: Cross-sectional study involving 30 individuals selected by convenience, divided into COPD group (n = 19) and control group (CG; n = 12). All participants were submitted to heart beat recordings during five minutes at rest (SB) and another five minutes during CB performed at six cycles/min. CAM was made by assessment of the heart rate variability (HRV) through time domain (TD) and frequency domain (FD). Comparisons between groups were performed by Mann Whitney test, and significance level was set at p < 0.05. Results: During SB, HRV TD and FD indices were higher in the controls than in the COPD group, respectively - RR intervals (53.2 ms versus 36.6 ms), RMSSD (42.1 ms versus 26.6 ms) (p < 0.05), total power (28322.8 ms2/Hz versus 2011.6 ms2/Hz), and high-frequency band (800.5 ms(2) versus 330.7 ms2). During CB, the CG also showed higher values for the TD parameters pNN50 (11.7% versus 5.1%), RMSSD (48.3 ms versus 26.7 ms), and SD of RRi (64.9 ms versus 44.7 ms), as well as for the low-frequency component of FD analysis (2848.6 ms2 versus 1197.9 ms2). Conclusion: COPD patients have different CAM when compared with healthy individuals during spontaneous (SB) and controlled breathing (CB).