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. 1987 Sep-Oct;34(5):164–170.

Midazolam: Review of a Versatile Agent for Use in Dentistry

Joseph A Giovannitti
PMCID: PMC2148551  PMID: 3318568

Abstract

Midazolam is a relatively new benzodiazepine that is widely used in both medicine and dentistry. Its multiplicity of uses makes it unique among the benzodiazepines, and its water solubility and lack of active metabolites give it distinct advantages over diazepam. This paper reviews the clinical pharmacology of midazolam, provides comparison with diazepam and presents current information regarding its indications, limitations, advantages, disadvantages, methods of administration and precautions for use.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Al-Khudhairi D., Whitwam J. G., McCloy R. F. Midazolam and diazepam for gastroscopy. Anaesthesia. 1982 Oct;37(10):1002–1006. doi: 10.1111/j.1365-2044.1982.tb01712.x. [DOI] [PubMed] [Google Scholar]
  2. Arendt R. M., Greenblatt D. J., deJong R. H., Bonin J. D., Abernethy D. R., Ehrenberg B. L., Giles H. G., Sellers E. M., Shader R. I. In vitro correlates of benzodiazepine cerebrospinal fluid uptake, pharmacodynamic action and peripheral distribution. J Pharmacol Exp Ther. 1983 Oct;227(1):98–106. [PubMed] [Google Scholar]
  3. Aun C., Flynn P. J., Richards J., Major E. A comparison of midazolam and diazepam for intravenous sedation in dentistry. Anaesthesia. 1984 Jun;39(6):589–593. doi: 10.1111/j.1365-2044.1984.tb07370.x. [DOI] [PubMed] [Google Scholar]
  4. Barclay J. K., Hunter K. M., McMillan W. Midazolam and diazepam compared as sedatives for outpatient surgery under local analgesia. Oral Surg Oral Med Oral Pathol. 1985 Apr;59(4):349–355. doi: 10.1016/0030-4220(85)90056-8. [DOI] [PubMed] [Google Scholar]
  5. Berggren L., Eriksson I. Midazolam for induction of anaesthesia in outpatients: a comparison with thiopentone. Acta Anaesthesiol Scand. 1981 Dec;25(6):492–496. doi: 10.1111/j.1399-6576.1981.tb01693.x. [DOI] [PubMed] [Google Scholar]
  6. Caldwell C. B., Gross J. B. Physostigmine reversal of midazolam-induced sedation. Anesthesiology. 1982 Aug;57(2):125–127. doi: 10.1097/00000542-198208000-00011. [DOI] [PubMed] [Google Scholar]
  7. Cheng S. C., Brunner E. A. Inhibition of GABA metabolism in rat brain synaptosomes by midazolam (RO-21-3981). Anesthesiology. 1981 Jul;55(1):41–45. doi: 10.1097/00000542-198107000-00009. [DOI] [PubMed] [Google Scholar]
  8. Cole W. H. Midazolam in paediatric anaesthesia. Anaesth Intensive Care. 1982 Feb;10(1):36–39. doi: 10.1177/0310057X8201000108. [DOI] [PubMed] [Google Scholar]
  9. Cooper S. J. Specific benzodiazepine antagonist RO15-1788 and thirst-induced drinking in the rat. Neuropharmacology. 1982 May;21(5):483–486. doi: 10.1016/0028-3908(82)90036-3. [DOI] [PubMed] [Google Scholar]
  10. Crawford M. E., Carl P., Andersen R. S., Mikkelsen B. O. Comparison between midazolam and thiopentone-based balanced anaesthesia for day-case surgery. Br J Anaesth. 1984 Feb;56(2):165–169. doi: 10.1093/bja/56.2.165. [DOI] [PubMed] [Google Scholar]
  11. Dionne R. A., Goldstein D. S., Wirdzek P. R. Effects of diazepam premedication and epinephrine-containing local anesthetic on cardiovascular and plasma catecholamine responses to oral surgery. Anesth Analg. 1984 Jul;63(7):640–646. [PubMed] [Google Scholar]
  12. Forster A., Gardaz J. P., Suter P. M., Gemperle M. Respiratory depression by midazolam and diazepam. Anesthesiology. 1980 Dec;53(6):494–497. doi: 10.1097/00000542-198012000-00010. [DOI] [PubMed] [Google Scholar]
  13. Fragen R. J., Gahl F., Caldwell N. A water-soluble benzodiazepine, RO21-3981, for induction of anesthesia. Anesthesiology. 1978 Jul;49(1):41–43. doi: 10.1097/00000542-197807000-00012. [DOI] [PubMed] [Google Scholar]
  14. Gerecke M. Chemical structure and properties of midazolam compared with other benzodiazepines. Br J Clin Pharmacol. 1983;16 (Suppl 1):11S–16S. doi: 10.1111/j.1365-2125.1983.tb02266.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Gross J. B., Zebrowski M. E., Carel W. D., Gardner S., Smith T. C. Time course of ventilatory depression after thiopental and midazolam in normal subjects and in patients with chronic obstructive pulmonary disease. Anesthesiology. 1983 Jun;58(6):540–544. doi: 10.1097/00000542-198306000-00011. [DOI] [PubMed] [Google Scholar]
  16. Lebowitz P. W., Cote M. E., Daniels A. L., Martyn J. A., Teplick R. S., Davison J. K., Sunder N. Cardiovascular effects of midazolam and thiopentone for induction of anaesthesia in ill surgical patients. Can Anaesth Soc J. 1983 Jan;30(1):19–23. doi: 10.1007/BF03007711. [DOI] [PubMed] [Google Scholar]
  17. McGimpsey J. G., Kawar P., Gamble J. A., Browne E. S., Dundee J. W. Midazolam in dentistry. Br Dent J. 1983 Jul 23;155(2):47–50. doi: 10.1038/sj.bdj.4805120. [DOI] [PubMed] [Google Scholar]
  18. Ochs M. W., Tucker M. R., White R. P., Jr, Anderson J. A. Recovery following sedation with midazolam or diazepam alone or in combination with fentanyl for outpatient surgery. Anesth Prog. 1986 Sep-Oct;33(5):230–234. [PMC free article] [PubMed] [Google Scholar]
  19. Pagano R. R., Graham C. W., Galligan M., Conner J. T., Katz R. L. Histopathology of veins after intravenous lorazepam and RO 21-3981. Can Anaesth Soc J. 1978 Jan;25(1):50–52. doi: 10.1007/BF03006784. [DOI] [PubMed] [Google Scholar]
  20. Power S. J., Morgan M., Chakrabarti M. K. Carbon dioxide response curves following midazolam and diazepam. Br J Anaesth. 1983 Sep;55(9):837–841. doi: 10.1093/bja/55.9.837. [DOI] [PubMed] [Google Scholar]
  21. Reves J. G., Fragen R. J., Vinik H. R., Greenblatt D. J. Midazolam: pharmacology and uses. Anesthesiology. 1985 Mar;62(3):310–324. [PubMed] [Google Scholar]
  22. Reves J. G., Samuelson P. N., Lewis S. Midazolam maleate induction in patients with ischaemic heart disease: haemodynamic observations. Can Anaesth Soc J. 1979 Sep;26(5):402–409. doi: 10.1007/BF03006455. [DOI] [PubMed] [Google Scholar]
  23. Richter J. J. Current theories about the mechanisms of benzodiazepines and neuroleptic drugs. Anesthesiology. 1981 Jan;54(1):66–72. doi: 10.1097/00000542-198101000-00013. [DOI] [PubMed] [Google Scholar]
  24. Rita L., Seleny F. L., Mazurek A., Rabins S. Y. Intramuscular midazolam for pediatric preanesthetic sedation: a double-blind controlled study with morphine. Anesthesiology. 1985 Nov;63(5):528–531. doi: 10.1097/00000542-198511000-00009. [DOI] [PubMed] [Google Scholar]
  25. Rosenbaum N. L. The use of midazolam for intravenous sedation in general dental practice. An open assessment. Br Dent J. 1985 Feb 23;158(4):139–140. doi: 10.1038/sj.bdj.4805546. [DOI] [PubMed] [Google Scholar]
  26. Smith M. T., Heazlewood V., Eadie M. J., Brophy T. O., Tyrer J. H. Pharmacokinetics of midazolam in the aged. Eur J Clin Pharmacol. 1984;26(3):381–388. doi: 10.1007/BF00548771. [DOI] [PubMed] [Google Scholar]
  27. Study R. E., Barker J. L. Cellular mechanisms of benzodiazepine action. JAMA. 1982 Apr 16;247(15):2147–2151. [PubMed] [Google Scholar]
  28. Vinik H. R., Reves J. G., Wright D. Premedication with intramuscular midazolam: a prospective randomized double-blind controlled study. Anesth Analg. 1982 Nov;61(11):933–937. [PubMed] [Google Scholar]
  29. de Jong R. H., Bonin J. D. Benzodiazepines protect mice from local anesthetic convulsions and deaths. Anesth Analg. 1981 Jun;60(6):385–389. [PubMed] [Google Scholar]

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