BJA Advance Access originally published online on September 4, 2008
British Journal of Anaesthesia 2008 101(5):632-639; doi:10.1093/bja/aen251
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Effects of age and gender on intravenous midazolam premedication: a randomized double-blind study
1 Department of Anaesthesiology, Yuli Veterans Hospital, No. 91, Xinxing Street, Yuli Town, Hualian County 981, Taiwan, Republic of China
2 Institute of Neuroscience, Tzu Chi University, Hualien, Taiwan, Republic of China
3 Department of Nursing, I-Shou University, No. 8, Yida Road, Yanchao Township, Kaohsiung County 82445, Taiwan, Republic of China
4 Department of Anaesthesia, Kaohsiung Veterans Hospital, No. 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan, Republic of China
5 Institute of Cognitive Science, National Cheng Kung University, 1 University Road, Tainan 701, Taiwan, Republic of China
* Corresponding author. E-mail: fzshaw{at}yahoo.com.tw
Background: Given the potentially important effects that age and gender may have on midazolam premedication, this study aimed at determining if these factors alter anxiety, sedation, and cardiorespiratory outcomes when administering two different doses of i.v. midazolam.
Methods: After randomization, patients were premedicated 1 h before surgery with either i.v. midazolam 0.02 or 0.06 mg kg–1 depending on their age and gender group. Levels of anxiety and sedation, heart rate, respiratory rate (RR), mean blood pressure (MBP), and oxygen saturation (SpO2) were measured before and 15 min after midazolam administration.
Results: A higher level of preoperative anxiety was more often observed in women than in men, and in young than in older patients. The female or younger patients showed significant anxiolytic benefits from midazolam. A deeper sedation level was found in men compared with women. Forty-two of 45 patients (93.3%) with excessive sedation received midazolam 0.06 mg kg–1. The elderly patients receiving midazolam 0.06 mg kg–1 showed significant reductions in MBP, RR, and SpO2. Of the patients with an SpO2<90%, 72.7% had received midazolam 0.06 mg kg–1.
Conclusions: Age and gender differences in neuropsychological and physiological responses after midazolam premedication were evident. Midazolam is effective for producing sedation and anxiolysis at a dose of 0.02 mg kg–1, with minimal effects on cardiorespiration and oxygen saturation to patients. Dosage adjustments based on these covariates are, therefore, necessary.
Keywords: age factors; cardiovascular system, responses; pharmacology, midazolam; premedication, midazolam
G.-C.S and M.-C.H contributed equally to this work.
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