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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.
Insights
Intramuscular midazolam did not significantly reduce pre-operative anxiety in this study. Anxiety scores remained unchanged in both the midazolam and placebo groups, indicating no anxiolytic effect.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Previous studies on midazolam's anxiolytic effects are inconclusive.
- Pre-treatment anxiety differences between groups may confound results.
Purpose of the Study:
- To re-evaluate the anxiolytic effect of intramuscular midazolam.
- To control for pre-treatment anxiety differences with a sufficiently powered sample size.
Main Methods:
- A randomized controlled trial with 96 patients.
- Patients received either midazolam (0.07 mg/kg IM) or placebo.
- Anxiety scores were measured before and 60 minutes after injection.
Main Results:
- No significant difference in anxiety scores between midazolam and placebo groups at baseline or 60 minutes.
- No significant change in anxiety scores from pre-treatment to post-treatment within either group.
Conclusions:
- Intramuscular midazolam did not demonstrate a statistically significant anxiolytic effect at 60 minutes post-administration.
- This study suggests midazolam may not be effective for pre-operative anxiety when administered intramuscularly.