The Hip: Preservation, Replacement and Revision

Mydazolam/Versed



- Discussion:
    - for preoperative sedation; impairment of memory of perioperative events;
    - sedation for procedures, short acting benzodiazepine:
    - versed is 3 to 4 times more powerful per mg. than valium
    - may dilute injection in D5W, NS, or LR;

- Conscious Sedation:
    - Dose: 0.1-0.2 mg/kg/dose IM/IV;  1.0 mg/kg/dose PR;
    - Adult: Sedation: 0.07-.08mg/kg/dose IM 15min-1hr. prior to procedure;
         or: 0.035mg/kg/dose repeated as prn; max: 0.2mg/kg/ total;
    - 1 mg/ml IV, no more than 2.5 mg should be given over a period of 2 min;
         - wait another 2 min. to evaluate sedative effects;
    - a total dose of greater than 5 mg is not usually necessary;
    - decrease the dose in the elderly;

- Peds: Bolus:
    - 0.05-0.3 mg/kg IV q1-2 hrs;
    - children may be more resistant to versed and have faster elimination than adults;

- Gen Anesthesia:
    - 0.3-0.5mg/kg IV, then incr in increments by .07-.09mg/kg up to a total of 0.6mg/kg to induce anesthesia; Monitor respiration;
    - IM: Onset: at 15 min; Peak at 30-60 min.
    - IV: sedative effects: at 3-5 min; duration: 20-30 min;

- Midazolam is well-absorbed PO and IM; onset of anesthesia following IV administration occurs 1 to 1.5 minutes, slower than thiopental but faster than diazepam; 
        the drug is metabolized in the liver and excreted in the urine (0.3% unchanged); 
        the elimination half-life is 2 to 5 hours;
        midazolam is highly protein-bound (95%).



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, July 30, 2012 4:17 pm