A Re-Evaluation of the Anxiolytic Properties of Intramuscular Midazolam

Abstract

The observed effect of midazolam on anxiety is equivocal in part because previous studies have not ruled out pre-treatment differences in anxiety scores between patients who received midazolam and those who did not (controls). This study re-examines the anxiolytic effect of premedication with intramuscular midazolam using a sample size calculated to be of sufficient size to rule out population differences as a variable affecting treatment results. In the midazolam group (n = 49) anxiety scores were determined prior to administration of midazolam 0.07 mg/kg intramuscularly, and again 60 minutes later. In the control group (n = 47) anxiety scores were determined prior to intramuscular injection of a similar volume of matching placebo (midazolam vehicle), and again 60 minutes later. No differences in anxiety scores between groups either before treatments or 60 minutes after treatments were observed. Within both groups, anxiety scores at 60 minutes were no different from pre-treatment scores. In this study midazolam did not produce a statistically significant decrease in pre-operative anxiety scores at 60 minutes following intramuscular administration.

Oral premedication one hour before minor gynaecological surgery — does it have any effect?

“…In two previous studies of lorazepam 2.5 or 5 mg, pronounced sedative effects were seen within one hour but still only marginal anxiolytic effect (10,13). There are also others who have failed to find any significant differences as regards anxiolysis between intramuscular premedication with other active drugs and placebo (16)(17)(18)(19)(20). In accordance with the present study both van Wijhe et al and Larsson et al found increased anxiety among more than 10% of patients after active drugs (1 9, 20).…”

Comparison of the effects of cranial electrotherapy stimulation and midazolam as preoperative treatment in geriatric patients: A CONSORT-compliant randomized controlled trial

“…[8,27] This dosage is reported to produce adequate sedation without significantly altering blood pressure or HR. [43] In the study of Rochette et al, [44] where midazolam 0.10 mg/kg IM was premedicated in patients with mean age of 73.8 ± 8.2 years, 95% of patients experienced clinically satisfactory anxiolytic effect without adverse reactions. In the present study, however, the setting dose of midazolam was 0.07 mg/kg, the lowest dose in the recommended range, considering the physiologically reduced organ function and altered redistribution kinetics.…”