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The central nervous and cardiovascular effects of midazolam 0.15 mg kg−1 were studied in 20 healthy, unpremedicated volunteers (10 male and 10 female). No important side-effects were noted and the venous tolerance to midazolam was excellent. Three minutes after injection mean systolic arterial pressure decreased from 121±(SEM) 2 mm Hg to 115±(SEM) 2 mm Hg and diastolic pressure from 78±2 to 70±2 mm Hg (P <0.05), and these effects persisted for at least 20 mm. Heart rate increased from 77±4 beat mm−1 to 90±3 and 88±3 beat mm−1 1 and 3 mm after the injection (P <0.05). Anterograde amnesia (40±3 min duration) and drowsiness (lasting 128±23 mm) were observed in all subjects. Loss of the eyelash reflex and apnoea were observed more often in the male group than in the female subjects. Midazolam 0.15 mg kg−1 was not sufficient to induce anaesthesia reliably in healthy unpretnedicated volunteers

In this report we present the case of a 77-yr-old man who underwent resection of the upper lobe of the left lung for a carcinoma, six weeks after percutaneous transluminal coronary angioplasty (PTCA) with stenting of the left anterior descending (LAD) and circumflex coronary arteries. Antiplatelet therapy with clopidogrel was interrupted two weeks before surgery to allow for epidural catheter placement and to minimize haemorrhage. The surgical procedure was uneventful. In the immediate postoperative period, however, the patient suffered severe myocardial ischaemia. Emergency coronary angiography showed complete thrombotic occlusion of the LAD stent. In spite of successful recanalization, reinfarction occurred and the patient died in cardiogenic shock. Prophylactic preoperative coronary stenting may put the patient at risk of stent thrombosis if surgery cannot be postponed for three months. In such cases, other strategies such as perioperative β-blockade for preoperative cardiac management should be considered. Br J Anaesth 2004; 92: 743-7

The central nervous and cardiovascular effects of midazolam 0.15 mg kg−1 were studied in 20 healthy, unpremedicated volunteers (10 male and 10 female). No important side-effects were noted and the venous tolerance to midazolam was excellent. Three minutes after injection mean systolic arterial pressure decreased from 121±(SEM) 2 mm Hg to 115±(SEM) 2 mm Hg and diastolic pressure from 78±2 to 70±2 mm Hg (P <0.05), and these effects persisted for at least 20 mm. Heart rate increased from 77±4 beat mm−1 to 90±3 and 88±3 beat mm−1 1 and 3 mm after the injection (P <0.05). Anterograde amnesia (40±3 min duration) and drowsiness (lasting 128±23 mm) were observed in all subjects. Loss of the eyelash reflex and apnoea were observed more often in the male group than in the female subjects. Midazolam 0.15 mg kg−1 was not sufficient to induce anaesthesia reliably in healthy unpretnedicated volunteers