ABSTRACT
Midazolam 0.3 mg/kg and diazepam 0.5 mg/kg were used for induction of anaesthesia in two groups of 10 patients each undergoing coronary artery bypass surgery. Haemodynamic variables were measured during induction of anaesthesia, after pancuronium and following tracheal intubation. Haemodynamic indices were derived from these measurements using standard formulae. The induction of anaesthesia with midazolam produced a slight but significant increase in heart rate. There was a significant fall in systemic arterial pressure and pulmonary artery pressure following both drugs. Despite the fall in systemic arterial pressure, the cardiac index was maintained in patients who received midazolam. The cardio-stimulatory effect of laryngoscopy and tracheal intubation was not prevented by either of the benzodiazepines and morphine in the dosage used. Midazolam is a suitable alternative to diazepam as part of an intravenous induction regimen in patients with ischaemic heart disease.
Subject(s)
Anesthesia, Intravenous , Benzodiazepines/pharmacology , Coronary Artery Bypass , Diazepam/pharmacology , Hemodynamics/drug effects , Hypnotics and Sedatives/pharmacology , Coronary Disease/physiopathology , Female , Humans , Intubation, Intratracheal , Male , Midazolam , Middle Aged , Time FactorsABSTRACT
A water-soluble benzodiazepine, midazolam, was used in 400 patients undergoing upper gastrointestinal endoscopy, alone or in combination with pentazocine and compared with 68 patients given diazepam (Valium). In the last 200 patients the endoscopist used midazolam without the presence of an anaesthetist. The absence of injection pain was the most notable feature of midazolam. The degree of co-operation was similar in all groups but the operating conditions were significantly better when midazolam was combined with pentazocine. There was no significant difference in recovery times between the groups as assessed by the pegboard test. Midazolam is an acceptable alternative to diazepam for upper gastrointestinal endoscopy.
Subject(s)
Anesthetics , Benzodiazepines , Duodenoscopy , Esophagoscopy , Gastroscopy , Adult , Anesthetics/pharmacology , Benzodiazepines/pharmacology , Diazepam/pharmacology , Female , Gagging/drug effects , Gastrointestinal Motility/drug effects , Humans , Male , Midazolam , Middle AgedABSTRACT
Midazolam, a water-soluble benzodiazepine, was given intravenously in doses of 0.07 mg/kg as sedation prior to oesophago-gastro-duodenoscopy in 40 patients. This was very effective as a sedative in elderly patients but less so in the young, with a large individual variation in response. Pain on injection and venous thrombosis which are common with diazepam were not seen with midazolam.
Subject(s)
Benzodiazepines , Gastroscopy , Hypnotics and Sedatives , Premedication , Adult , Aged , Aging , Atropine/pharmacology , Benzodiazepines/administration & dosage , Humans , Injections, Intravenous , Midazolam , Middle AgedSubject(s)
Anesthetics/adverse effects , Benzodiazepines/adverse effects , Chemical and Drug Induced Liver Injury , Phenols/adverse effects , Adolescent , Adult , Aged , Anesthesia, Intravenous/adverse effects , Female , Humans , Liver/enzymology , Liver Function Tests , Midazolam , Middle Aged , Propofol , Thiopental/adverse effectsABSTRACT
Midazolam, a new water-soluble benzodiazepine, was investigated as an intravenous anaesthetic agent in 260 adult patients in doses ranging from 0.15 to 0.5 mg/kg using a variety of premedications. Its onset of action was generally slow, taking up to 3 minutes to exert its maximum effect. A wide variability in response was found in that some unpremedicated patients were satisfactorily anaesthetised with 0.15 mg/kg while other were only moderately sedated following doses of 0.5 mg/kg. Less variability was found in the elderly who also required smaller doses. Narcotic premedication potentiated the sedative effect of midazolam. Few respiratory or cardiovascular effects were noted apart from hiccough following the larger doses. The incidence of venous sequelae was much lower than that found following diazepam.
