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Midazolam and Fat‐Emulsion Diazepam as Intramuscular Premedication A Double‐Blind Clinical Trial
Author(s) -
Mattila M. A. K.,
Suurinkeroinen S.,
Säilä K.,
Himberg J.J.
Publication year - 1983
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1983.tb01965.x
Subject(s) - diazepam , midazolam , premedication , medicine , anesthesia , sedation , sedative , hypnotic
Sixty female patients were given, in random order, under double‐blind conditions, either midazolam or fat‐emulsion diazepam, intramuscularly, as premedication, 1 h before general anaesthesia. The dose of midazolam used was 0. 13mg/kgand that of diazepam 0.17 mg/kg. The degree of sedation, mood of the patient, and time at which onset of effect was perceptible were assessed before induction of anaesthesia, together with skin temperature and concentrations of midazolam or diazepam in plasma. Patients were interviewed postoperatively to discover their subjective evaluation of the premedication and to assess its amnesic effects. Midazolam was significantly superior ( P <0.05) to diazepam as regards sedation. There were no differences in effects on mood of the patients between the two groups. Sixteen patients in the diazepam group and four in the midazolam group had no perception of onset of effect. The difference is significant ( P <0.01). The skin temperature was, on average, 2°C higher in the midazolam group than in the diazepam group ( P <0.005). The mean plasma concentration was 67.8 ±24.5 μg/l in the midazolam group and 44.8 ±25.7 μg/l in the diazepam group. In only two cases was the concentration of diazepam above 100 μg/l (arbitrarily defined as the minimum sedative concentration). Subjective evaluation of efficacy significantly ( P <0.002) favoured midazolam. Local pain was evident in two patients in the diazepam group, and three patients experienced nausea immediately after administration of the drug. Intramuscularly administered midazolam seems to be a very satisfactory premedicant, with a rapid onset of sedative effect, and good tolerance. Fat‐emulsion diazepam cannot be recommended for intramuscular administration because it is not well absorbed.