[Haemodynamic effects and characteristics of midazolam during induction of anesthesia (author's transl)]

Our investigations have shown the following: 1. 8-Chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine (midazolam, Ro 21-3981, Dormicum) produces no adverse haemodynamic changes in healthy subjects. 2. The reduction in peripheral resistance becomes apparent mainly in the case of raised baseline values, as, for example, in hypertensive subjects, but it can also be of significance prior to anaesthesia, when there may be raised systemic vascular resistance due to stress. 3. Venous pooling, which leads to a decrease in pre-load and subsequent lowering of the cardiac index, can have a compensatory effect in cardiac insufficiency. Under certain conditions, as for example, in the case of imminent volume deficit, a marked fall in pressure is to be expected. 4. The haemodynamic effects of midazolam are thus limited to vascular reactions. Under certain circumstances volume therapy may be necessary before the drug is used.