The Effects of Age and Gender on the Optimal Premedication Dose of Intramuscular Midazolam

Abstract

We conducted a double-blind study on the effects of age and gender on the optimal premedication dose of IM midazolam. We randomly divided 100 male and 100 female patients in each of three age groups: A = 20-39 yr, B = 40-59 yr, and C = 60-79 yr (total 600 patients) into five groups according to midazolam dosage: 0.04, 0.06, 0.08, 0.10, and 0.12 mg/kg. Midazolam was injected IM with atropine 0.01 mg/kg 15 min before the induction of anesthesia. Blood pressure (BP), heart rate, respiratory rate, oxygen saturation (SpO2), sedation level, tongue root depression, eyelash reflex, and anterograde amnesia were monitored. There were no significant differences between male and female patients in any variables in any age. Decrease of SpO2 and loss of eyelash reflex were seen with midazolam 0.10 mg/kg in Group A, and with 0.08 mg/kg in Group B. In Group C, decreases in BP and SpO2, loss of eyelash reflex, and depression of the tongue root were observed with midazolam 0.06 mg/kg. In conclusion, the optimal doses of IM midazolam administered 15 min before the induction of anesthesia in male or female patients were 0.08, 0.06, and 0.04 mg/kg for Groups A, B, and C, respectively. Implications: Midazolam is the most widely used preoperative anxiolytic drug. Our purpose was to evaluate the optimal dose of IM midazolam that would maximize the desired effects and minimize the side effects in a common clinical setting. Results indicate that age, but not gender, should affect the IM midazolam dose selected for premedication. (Anesth Analg 1998;86:1103-8)