The use of midazolam in premedication

Socio-psychological factors, such as increased anxiety in developed societies and cultures, and separation anxiety, particularly in children, justify the use of premedicants. In addition, the link between a central nervous "anxiety centre" and biochemical stress responses is blocked by an efficient anxiolytic. The elimination half-life of midazolam is longer in the elderly than in the young and in the obese than in the thin, which demands longer intervals between repeated doses in old and fat patients. The hypoxic ventilatory response is depressed in most patients and the ventilatory CO2 response in patients with chronic pulmonary disorders, which justifies increased monitoring of O2 saturations. It is important for the choice of dose and for estimating the duration of recovery time to know that midazolam is at least four times as potent as diazepam.