Midazolam: an induction agent for general anesthesia.

Midazolam is the first water soluble sedative widely used as an adjunct agent in general anesthesia. This 1,4-benzodiazepine derivative has been found to be a versatile agent, used as a premedicant, a hypnotic, an adjunct to intravenous conscious sedation, a long-term infused sedative agent, and more recently as an induction agent in selected situations. This report provides descriptive observations of midazolam used as an induction agent in 50 American Society of Anesthesiologists class I through III patients undergoing general anesthesia for elective or selected emergency surgeries. All inductions were preceded by 10 to 20 micrograms sufentanil. The use of sufentanil prior to the induction dose of midazolam facilitated a quicker onset of unconsciousness. Induction was smooth but gradual, and the course of anesthesia was otherwise satisfactory. Patients were alert and awake in the postanesthesia care unit. Recovery time was not prolonged due to somnolence or disorientation.