• P F White, L O Vasconez, S A Mathes, W L Way, and L A Wender.
• Department of Anesthesia, Stanford University School of Medicine, Calif.
• Plast. Reconstr. Surg. 1988 May 1; 81 (5): 703-12.

AbstractA randomized double-blind study was designed to compare midazolam, a rapid-acting water-soluble benzodiazepine, with diazepam for sedation when administered as an adjuvant to ketamine during local anesthesia. In the preliminary dose-ranging study, midazolam (0.05 to 0.15 mg/kg IV) was found to produce a spectrum of central nervous system activity (e.g., sedation, amnesia) that was similar to diazepam (0.1 to 0.3 mg/kg IV). However, the slope of midazolam's dose-response curve for sedation appeared to be steeper (i.e., a narrower therapeutic dosage range). In a comparative evaluation of their relative sedative-amnestic properties and recovery characteristics, the median effective doses of the two benzodiazepines were compared. Midazolam (0.1 mg/kg IV) was found to produce more profound sedation and amnesia than diazepam (0.2 mg/kg IV). Midazolam was associated with significantly less pain on injection and a lower incidence of postoperative venoirritation. Overall patient acceptance was higher with midazolam compared to diazepam. Finally, recovery characteristics were similar for the two benzodiazepines in our outpatient setting.

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