[The effects of midazolam on the general circulation, cerebral blood-flow and cerebral oxygen consumption in man (author's transl)].

The effects of midazolam, 0.2 mg/kg b.w., on cerebral blood flow, cerebral oxygen consumption and brain metabolism were studied in 8 patients scheduled for intracranial aneurysm surgery. All patients were anesthetized with fentanyl and N2O; arterial pCO2 and pO2 were maintained within the normal range by controlled ventilation. Midazolam produced minimal effects on the general circulation. Cerebral blood-flow decreased about 11% while cerebral oxygen consumption essentially remained unchanged. Cerebral perfusion pressure slightly decreased due to a reduction in mean aortic pressure. In three patients with elevated intracranial pressure midazolam decreased intracranial pressure significantly while there was no change in the other patients. It is concluded that midazolam is of no harm in patients with intracranial aneurysms. Furthermore this rapidly acting drug in addition to other measures might be of some benefit in patients with elevated intracranial pressure when immediate reduction of cerebral blood volume is desired.