Midazolam for induction of anaesthesia in patients with limited cardiac reserves. A comparison with etomidate

The new water-soluble benzodiazepine, midazolam (Dormicum; Roche), was compared with etomidate as part of a balanced technique for induction of anaesthesia in 16 patients undergoing cardiac valve replacement. Monitoring revealed a significantly greater fall in blood pressure in patients receiving midazolam (reaching dangerous levels in 2 patients), which suggests that this agent is not suitable for induction of anaesthesia in haemodynamically compromised patients.