Anxiolytic Efficacy of Midazolam Premedication Among Surgical Patients: A Clinical Evaluation from Routine Practice

Open Access

Abstract

Background: Midazolam is a short-acting benzodiazepine that is commonly used as a premedication due to its anxiolytic, sedative, and amnestic effects. This study aimed to assess the anxiolytic effect and perioperative safety of midazolam premedication in surgical patients. Methods & Materials: This descriptive observational study was carried out in the Department of Anaesthesiology & ICU, International Medical College Hospital, Gazipur, Bangladesh, from January 2025 to December 2025, on 130 patients who were undergoing elective or semi-emergency surgery and were given midazolam as part of their routine anesthetic care. Sociodemographic characteristics, clinical and surgical profile, premedication characteristics, change in anxiety level, and perioperative outcomes were recorded and analyzed descriptively. Results: Most patients were in the age group of 31-50 years (67.7%), and there was almost equal distribution of males and females. Of the 69.2% who had moderate to severe anxiety before premedication, the primary concerns were fear of postoperative pain and anesthesia. Oral midazolam (63.1%) at a dose of 0.04-0.05 mg/kg (55.4%) was most frequently used and resulted in a calm and cooperative response in 80.0% of patients. Minimal anxiety increased from 9.2% to 52.3% after premedication, and 80.8% of patients had a satisfactory anxiolytic response. Hemodynamic stability was achieved in 91.5% of patients, and there was a low incidence of nausea/vomiting (5.4%) and paradoxical agitation (3.1%). Conclusion: Midazolam premedication was found to be an effective and safe anxiolytic in routine clinical practice in surgical patients, and is therefore recommended as a useful premedication in tertiary care centers.