Midazolam General anaesthetics

INDIRECT ANAESTHETICS-GENERAL 1. Risk of arrhythmias when inhalational anaesthetics are coadministered with methylphenidate 2. Case report of 1 sedative effect of midazolam and ketamine from methylphenidate 1. Uncertain it is possible that inhalational anaesthetics sensitize the myocardium to sympathetic stimulation 2. Uncertain at present Avoid giving methylphenidate on the day of elective surgery... 

For reports of enhanced sedation when propofol is given with midazolam, thiopental or other anaesthetics, see Anaesthetics, general + Benzodiazepines , p.96. 

Sedation and amnesia without analgesia are provided by midazolam i.v. or, less commonly nowadays, diazepam. These drugs can be used alone for procedures causing mild discomfort, e.g. endoscopy, and with a local anaesthetic where more pain is expected, e.g., removal of impacted wisdom teeth. Benzodiazepines produce anterograde, but not retrograde, amnesia. By definition, the sedated patient remains responsive and cooperative. (For a general account of benzodiazepines and the competitive antagonist flumazenil, see Ch. 19.)... 

The interactions between propofol or thiopental and midazolam are well established. This synergy has been utilised for the induction of anaesthesia. Midazolam also reduces the dose requirements of halothane. Other benzodiazepines may also potentiate the effects of general anaesthetics. 

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