[Midazolam (Dormicum) as oral premedication for local anesthesia]

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Effective premedication is crucial for patient comfort during local anesthesia surgery.
• Midazolam (Dormicum) is a benzodiazepine with established intravenous and intramuscular use, but limited data on oral administration.
• Oral administration of midazolam for premedication requires further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of oral midazolam as a premedication for ophthalmic surgery under local anesthesia.
• To compare the anxiolytic, sedative, and amnesic effects of two oral midazolam dosages with diazepam and placebo.

Main Methods:

• A randomized, double-blind, placebo-controlled study involving 120 patients undergoing ophthalmic surgery.
• Four groups received oral premedication: 7.5 mg midazolam, 15 mg midazolam, 10 mg diazepam, or placebo, one hour prior to surgery.
• Anxiolysis (STAI), sedation (Pandit et al.), amnesia (picture recall), and side-effects were assessed post-medication and on the first postoperative day.

Main Results:

• Anxiety significantly decreased with diazepam and more markedly with both 7.5 mg and 15 mg midazolam compared to placebo.
• Sedation increased similarly across benzodiazepine groups at 50 minutes post-administration.
• The sedative effect was most pronounced with 15 mg midazolam at 90 minutes, though its duration was shorter than diazepam's.

Conclusions:

• Oral midazolam, in both 7.5 mg and 15 mg doses, demonstrates significant anxiolytic effects for patients undergoing local anesthesia.
• Midazolam provides effective sedation, with the 15 mg dose showing the most pronounced effect at 90 minutes.
• Oral midazolam is a promising alternative for premedication in patients undergoing surgery under local anesthesia.