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Anesthesia

Midazolam (Versed®)

Midazolam is a drug known commonly by its trade name, Versed.® Midazolam is thought to work mainly by blocking certain brain receptors called GABA receptors. Because it has many favorable properties including quick onset and a short duration of action, midazolam is a preferred sedative drug in many countries around the world.

Midazolam's effects include:

Depending on the dose given, midazolam can produce mild, moderate, or deep sedation.

Midazolam is not a pain-relieving drug.

Midazolam Administration

Midazolam is administered by:

Anyone who administers midazolam must have the ability to deal with the problems that can result from too much sedation such as obstruction of the airway, reduced breathing, or, occasionally, decreased blood pressure. A drug that reverses the effects of midazolam is available (Flumazenil).

Midazolam is usually given intravenously before or during surgery or medical procedures. Pills are also available. Midazolam, like other intravenous sedative drugs, is usually given in small initial doses. The effect of the drug is observed then more is given as needed.

Complications of Midazolam (Versed ®)

Midazolam is a very safe and effective drug but, like any medication, has potential side effects.

Delirium and Confusion - In certain patients midazolam may produce unusual behavior and loss of control, not unlike the effects of alcohol. In some patients, particularly the elderly, confusion or difficulty with thinking that outlasts the medical or surgical procedure may be experienced during recovery in the hospital and at home.

Amnesia - Most patients do not wish for awareness during surgery. The amnesia-producing effects of midazolam are therefore welcomed. A few patients seem to find the amnesia from midazolam unpleasant. However the amnestic properties of midazolam are not unique and are shared with other drugs in its class (benzodiazepines) as well as other sedatives (e.g. propofol) and anesthetic gases.

Allergies or Intolerance - Allergy to midazolam is rare. Tell your doctor if you have ever had an unusual or allergic reaction to midazolam or any other benzodiazepines.

Pregnancy and Breast-Feeding - Other benzodiazepines have been associated with increased risk of birth defects when used in early pregnancy. You should discuss breast-feeding with your doctor because midazolam can be excreted in breast milk.

Advanced Age - The elderly are especially susceptible to the effects of midazolam, which may increase the chance of side effects.

Myasthenia Gravis - Midazolam, along with other sedatives, may make the symptoms of this condition worse.

After Midazolam Therapy

If you have received intravenous midazolam for sedation you should NOT drive or operate machinery until you are fully alert and able to function properly. In most cases, this is not until the day following your procedure but may be as long as 48 hours after administration of midazolam.

Your doctors will monitor you closely after you receive midazolam therapy for any side effects such as breathing problems and confusion. Other depressant medications may extend the effects of midazolam such as:

Most of the expected effects from midazolam (drowsiness, sleepiness) will wear off as the midazolam is processed through your body. If you have any lingering side effects, you should contact your physician immediately.

Talk to Your Anesthesia Provider

If you have any concerns, or feel that midazolam therapy is not for you, contact your physician. Let them know about this and together you can form a plan of care suited to your needs.

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Last Reviewed: Oct 05, 2010

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University