THE DILEMMA OF HEMODYNAMIC INSTABILITY DURING INDUCTION OF ANESTHESIA: CAN MIDAZOLAM SERVE AS A SUITABLE SUBSTITUTE FOR THIOPENTONE?

Both midazolam and thiopental sodium are being used as induction agents and for maintenance of anesthesia. In contrast to other benzodiazepines such as diazepam, midazolam has a rapid onset of action and fast distribution and causes few cardiovascular or respiratory effects. Being water soluble, midazolam is also associated with a low incidence of venous irritation. The purpose of this study was to see whether midazolam is a suitable substitute for thiopental sodium as an induction agent. To compare the hemodynamic changes associated with midazolam and thiopental sodium as induction agents, this study was conducted in two groups each comprising of 30 patients. No significant hemodynamic changes regarding heart rate and blood pressure could be noticed in the two groups (p<0.05). All patients in the midazolam group exhibited anterograde amnesia but in the thiopental group, 20% of the patients had recall for operative events one hour after completion of surgery. To arrive at more conclusive results, preferably multi-center studies involving large numbers of cases are recommended.