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Midazolam is a Schedule IV drug under the Convention on Psychotropic Substances. [81] In the United Kingdom, midazolam is a Schedule 3/Class C controlled drug. [ 82 ] In the United States, midazolam (DEA number 2884) is on the Schedule IV list of the Controlled Substances Act as a non-narcotic agent with low potential for abuse.
PO: oral • IV: intravenous injection • IM: intramuscular injection • SC: subcutaneous injection • SL: sublingual • TD: transdermal "Strength" is defined as analgesic potency relative to oral morphine. Tolerance, sensitization, cross-tolerance, metabolism, and hyperalgesia may be complex factors in some individuals.
Opioid, lidocaine and midazolam are adjuvant agents frequently administered to minimize pain during the injection of the induction agents. [45] [46] They are also used to lessen the sympathetic stress response, cough reflex during laryngoscopy or intubation, and supplement sedation by synergistic effects.
Additionally, IV sedation is frequently administered as a concoction of several agents including those previously mentioned for induction and maintenance of anesthesia, as well as a benzodiazepine (usually midazolam, but temazepam or flunitrazepam are also used via the oral route [4]) and a narcotic/systemic analgesic such as demerol or fentanyl.
The most commonly utilized benzodiazepine is Midazolam, which is characterized by a rapid onset and short duration. Midazolam is effective in reducing preoperative anxiety, including separation anxiety in children. [28] It also provides mild sedation, sympathicolysis, and anterograde amnesia. [6]
In the third group, all participants received midazolam only [5] Additionally, in all three trials participants received a medication for pain control [5] Trials 1 and 2 compared participants who received remimazolam to participants in the other two groups, measuring the success of sedation with the set of pre-determined criteria. [5]
Midazolam collects in the body's fatty tissues, so a possible complication includes prolonged sedation. As a result, the elderly, the obese, and those with kidney or liver disease are more vulnerable to prolonged sedation with midazolam. Respiratory depression is also associated with midazolam when given in high doses.
In medicine, specifically in end-of-life care, palliative sedation (also known as terminal sedation, continuous deep sedation, or sedation for intractable distress of a dying patient) is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative ...