[Clinical use of midazolam].
Midazolam is widely used in anesthesia. This paper shows characteristics of midazolam and how to use midazolam in clinical anesthesia. As a premedication, midazolam should be injected i. m. 15 min before entering an operating room in a dose of 0.04 mg.kg-1 to 0.08 mg.kg-1 according to the patient's age. For anesthesia induction, midazolam should be used together with barbiturate or propofol to take advantage of synergistic effects. Continuous infusion of midazolam in total intravenous anesthesia with fentanyl results in hemodynamic stability and good postoperative analgesia. During spinal or epidural anesthesia, i.v. midazolam of 0.05 mg.kg-1 has anti-anxietic and sedative effects. Midazolam inhibits awakening during cardiopulmonary bypass and it has little cardiodepressant effect. In aged, hepatic damaged or renal damaged patients, the effects of midazolam are slightly increased. Therefore, lower doses may be required in such patients. In conclusion, midazolam is usable in premedication, induction, maintenance in general anesthesia and in sedation in local anesthesia.
Nishiyama
T
T
Department of Anesthesiology, Faculty of Medicine, University of Tokyo.
Furuya
C
C
Hanaoka
K
K
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D000775:Anesthesia, Spinal; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D001463:Barbiturates / Q000008:administration & dosage; D002648:Child; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D011229:Preanesthetic Medication; D015742:Propofol / Q000008:administration & dosage
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D014151:Anti-Anxiety Agents; D001463:Barbiturates; D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol