Midazolam is an effectual benzodiazepine, regularly used for humans and animals as part of a pre-surgical regimen. As a pre-anesthetic agent, Midazolam is typically used to help ease anxiety before surgical procedures, and induce amnesia so patients will essentially forget any uncomfortable thoughts regarding their preparation and pending surgery. Pets are often dispensed Midazolam alongside propofol to induce anesthesia prior to surgery, although the concomitant use of these drugs does necessitate an altered (lesser) dose of propofol. For canines the recommended dosage as pre-anesthesia is 0.25 mg/kg, dispensed intravenously. Human dosages vary based on procedures and needs, although the use of this fast acting central nervous system depressant is tolerable for the majority of patients. Unfortunately, the current drug shortage of Midazolam has left many pharmacies and practitioners, as well as patients, wondering how to proceed with surgical procedures without Midazolam.
Dispensed for adult patients as either an intramuscular injection or an intravenous infusion, the sedative effects of Midazolam vary based on the route of administration and whether other medications are adjunctively dispensed. Sedative effects in adults typically occur within 15 minutes of an intramuscular injection and 3 to 5 minutes after an I.V. infusion dosage. Studies have not shown a need for concern regarding neurotoxicity from Midazolam, and this clinically traditional pre-operative benzodiazepine has proven to be safe and efficacious in pregnant women as well. The use of Midazolam in subarachnoid blocks is a newer treatment protocol, but studies have offered data supporting this method of delivery. One such study in the Indian Journal of Pharmacology found that the use of Midazolam provided superior analgesia as compared to clonidine in a subarachnoid block, while eliciting fewer adverse effects as well. It is clear that the medical and veterinary communities worldwide are in need of this tolerable and effective medication.
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