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midazolam

✓ Approved

Rafa Laboratories Ltd · GABRA1 · 小分子

什么是 midazolam？

midazolam 是一种小分子，由Rafa Laboratories Ltd研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Intramuscular (IM) Injection。

药物档案

公司Rafa Laboratories Ltd
药物类别小分子
分子靶点GABRA1, GABRA2, GABRA3, GABRA4, GABRA5
给药途径Injectable (Others), Intramuscular (IM) Injection
状态Approved
来源： ClinicalTrials.gov, Rafa Laboratories Ltd

作用机制

分子靶点

midazolam 作用于 5 个分子靶点：

GABRA1gamma-aminobutyric acid type A receptor alpha1 subunit (DEE19, ECA4)
GABRA2gamma-aminobutyric acid type A receptor alpha2 subunit (DEE78, EIEE78)
GABRA3gamma-aminobutyric acid type A receptor alpha3 subunit (EPILX2)
GABRA4gamma-aminobutyric acid type A receptor alpha4 subunit ()
GABRA5gamma-aminobutyric acid type A receptor alpha5 subunit (EIEE79, DEE79)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

midazolam 针对 1 个适应症，涉及 1 个治疗领域。

治疗领域疾病/病症分期
Nervous system disordersStatus epilepticus✓ Approved

相关研究文献

PubMedJournal of pediatric and adolescent gynecology2026-06-13

Adolescent Experiences with Procedural Sedation for Intrauterine Device Placement: A Pilot Study.

Bryant Ellen E, Stancil Stephani S, Priebe Anne-Marie AM, Nos Andrea A et al.

This study examines adolescent experiences with intrauterine device (IUD) insertion under conscious sedation. We conducted a prospective pilot study of 11-21-year-olds who chose conscious sedation for their IUD insertion. Participants completed pre-procedure surveys (e.g., demographics, anticipated pain, reproductive history) and post-procedure surveys (e.g., pain during insertion and overall experience). Providers completed a survey on the day of IUD insertion with sedation type, complications, and reason for sedation. In 16 youth (16.1 ± 1.8 years), 14 received moderate sedation (intravenous midazolam and fentanyl) and 2 received light sedation (nitrous oxide). The most reported "worst part" was procedural cramps (n=5, 31%). The "best part" was sedation effects (n=7, 44%). All patients who received light sedation remembered the insertion compared to 2 of 14 (14%) patients who received moderate sedation. Patients reported an average satisfaction score of 83 on a 100-point visual analogue scale, with no difference between sedation types. Adolescents were highly satisfied with procedural sedation for IUD insertion. Fewer participants remembered the procedure when they received moderate compared to light sedation. IUDs are effective as reversible contraception and menstrual management. The pelvic exam and pain may discourage use of the IUD, but sedation offers an alternate experience. Examining patient experiences will help clinicians counsel future patients on their anticipated experience and provides evidence-based rationale for modification and expansion of this service.

PMID 42285392
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PubMedJournal of clinical medicine2026-06-12

Perioperative Anesthetic Factors and Flap Outcome in Pediatric Head and Neck Free Flap Reconstruction: A Retrospective Study.

Lech Dominika D, Maksymowicz Robert R, Matysek Jeremi J, Strączek Cyprian C et al.

Background: Microvascular free flap reconstruction is an established method for the management of complex head and neck defects in pediatric patients. However, the influence of perioperative anesthetic management on flap outcome in this population remains insufficiently defined. The aim of this study was to evaluate the association between selected perioperative anesthetic factors and flap outcome in pediatric patients. Methods: This retrospective observational study included pediatric patients undergoing microvascular free flap reconstruction between August 2011 and July 2020. Of 80 screened patients, 56 met the inclusion criteria based on complete medical records. Demographic, surgical, and perioperative anesthetic variables were collected. Continuous variables were compared using the Mann-Whitney U test, and categorical variables using the chi-squared test with Yates' correction. Correction for multiple testing was performed using the Benjamini-Hochberg false discovery rate procedure. Results: Complete flap survival was achieved in 50 patients (89.3%), while partial and total flap loss occurred in 3 patients each (5.4%). No significant associations with flap loss were identified for the type of anesthetic gas, opioid use, induction agents, intraoperative fluid therapy, diuresis, rocuronium dose, or operation time. Lower weight-adjusted doses of midazolam and propofol showed borderline unadjusted associations with flap loss; however, these differences did not reach statistical significance after correction for multiple testing. Patients with flap loss had a higher mean intraoperative body temperature compared to those with successful flap survival (36.65 °C vs. 36.05 °C; p < 0.05). Conclusions: In pediatric head and neck free flap reconstruction, most analyzed perioperative anesthetic factors were not associated with flap outcome. Dose-related findings for midazolam and propofol should be interpreted as exploratory and non-significant after correction for multiple testing, while higher intraoperative body temperature was associated with flap loss. However, these results are exploratory, cannot establish causality, and require confirmation in larger, preferably multicenter studies with adjustment for surgical and patient-related confounders.

PMID 42279181
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PubMedHealthcare (Basel, Switzerland)2026-06-12

Impact of Passive Smoking on Vital Signs, Motor Activity, and Agitation in Children Undergoing Dental Extractions Under Sedation: A Short-Term Cohort Study.

Kaplan Elif Buse EB, Avşar Aysun A

Passive smoking (PS) is a well-established risk factor associated with systemic and oral health impairments in children. However, its influence on perioperative physiological stability and recovery profiles during pediatric dental sedation remains insufficiently elucidated. This study investigated the association between PS exposure and perioperative vital parameters, recovery characteristics, and emergence behavioral outcomes in children undergoing dental extractions under sedation. This prospective cohort study (ClinicalTrials.gov: NCT06780189) included 100 ASA I children aged 4-6 years scheduled for primary molar extraction under midazolam-remifentanil-propofol sedation. Participants were stratified into three groups: no exposure, caregiver and household exposure, and household exposure only. An exposure-related relationship was evaluated based on daily household cigarette consumption. Perioperative vital signs (HR, blood pressure, and SpO2) were continuously monitored. Postoperative recovery and emergence profiles were assessed using the Modified Aldrete Recovery Score (MASS), Richmond Agitation-Sedation Scale (RASS), and Pediatric Anesthesia Emergence Delirium (PAED) scale. Children exposed to PS demonstrated significantly lower SpO2 levels across all perioperative phases compared with non-exposed counterparts (p < 0.001), reflecting an exposure-related effect. In contrast, no statistically significant differences were observed in cardiovascular parameters (p > 0.05). Recovery time was significantly prolonged in PS-exposed children (p = 0.002). Furthermore, PS exposure was associated with significantly higher RASS and PAED scores, indicating increased agitation and emergence delirium (p < 0.001). Passive smoking adversely affects perioperative oxygenation, delays recovery, and exacerbates emergence neurobehavioral disturbances in children undergoing dental sedation. Environmental tobacco exposure must be integrated into preoperative risk assessments.

PMID 42278704
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PubMedJournal of clinical medicine2026-06-12

Clinical and Hormonal Determinants of Propofol Requirement During Oocyte Pick-Up: A Prospective Observational Study.

Gürsoy Çirkinoğlu Gözde G, Kuvvet Yoldaş Tuba T, Ateşalp Aylin A, Şahinkaya Halide Hande HH et al.

Objectives: Oocyte pick-up (OPU) is commonly performed under propofol-based sedation during in vitro fertilization (IVF). However, considerable interindividual variability in propofol requirement has been observed. Controlled ovarian hyperstimulation results in supraphysiological levels of ovarian steroid hormones, which may influence anesthetic sensitivity. This study aimed to evaluate the relationship between preprocedural serum estradiol and progesterone levels and propofol requirement during OPU performed under bispectral index (BIS)-guided sedation. Methods: In this prospective observational study, 96 women undergoing OPU were included. Serum estradiol and progesterone levels measured on the day of the procedure were recorded. Sedation was performed using a standardized protocol with midazolam, fentanyl, and propofol titrated to maintain BIS values between 40 and 60. Propofol consumption was normalized to body weight (mg/kg) and procedure duration (μg/kg/min). Correlation analyses and multivariable linear regression models were used to evaluate associations. Results: Mean propofol consumption was 157.3 ± 53.1 mg (2.41 ± 0.83 mg/kg), corresponding to an infusion rate of 125.7 ± 69.6 μg/kg/min. In multivariable analysis, estradiol levels were independently associated with propofol requirement (β = 0.238, p = 0.014), whereas progesterone levels were not significantly associated with anesthetic dosing after adjustment. BMI (β = -0.305, p = 0.002) and procedure duration (β = 0.224, p = 0.021) were also identified as independent predictors. Conclusions: Estradiol levels were associated with propofol requirement during OPU performed under BIS-guided sedation. However, given the observational design and the modest magnitude of the observed associations, these findings should be interpreted cautiously. BMI and procedure duration appeared to be more consistent predictors of propofol administration.

PMID 42279141
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PubMedEuropean journal of pediatrics2026-06-12

Nationwide variability in sedation, analgesia, and developmental care practices during neonatal therapeutic hypothermia: A French national survey.

Osswald Claire C, Le Duc Kévin K, Chaton Laurence L, Joriot Sylvie S et al.

Analgesia, sedation and developmental care are key components of supportive management for newborns with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). However, evidence-based recommendations remain limited, and practices may vary substantially between centers. We aimed to describe current practices in analgesia, sedation, and developmental care during TH across French neonatal intensive care units (NICUs). We conducted a nationwide cross-sectional survey using a standardized electronic questionnaire distributed to all NICUs performing TH in France. Each center provided a single consolidated response. Descriptive statistics were used. Fifty-one of 63 eligible NICUs responded (80%), including 33 university and 18 general hospitals. Formal developmental care programs were available in 88% of centers. Routine endotracheal intubation during TH was reported by 71%. The most frequently used medications were midazolam (94%), sufentanil (88%), morphine (84%), and paracetamol (82%). Analgesia-sedation regimens and dosing strategies varied markedly across centers. Most NICUs (75%) expressed interest in developing protocols allowing TH without routine intubation. Substantial inter-center variability exists in analgesia, sedation, and developmental care practices during neonatal TH. These findings support the need for standardized, evidence-based protocols to optimize neonatal comfort and reduce practice heterogeneity. • Therapeutic hypothermia is the standard neuroprotective treatment for moderate-to-severe neonatal hypoxic-ischemic encephalopathy. • Analgesia, sedation, and supportive care during therapeutic hypothermia are widely used, but evidence-based recommendations remain limited. • This first nationwide French survey demonstrates marked inter-center variability in analgesia, sedation, developmental care, and routine intubation practices during neonatal therapeutic hypothermia. • These findings highlight the need for standardized, pharmacologically informed protocols during therapeutic hypothermia, prioritizing medications with more predictable metabolism and clearer pharmacokinetic-based dosing strategies.

PMID 42277340
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PubMedWorld journal of critical care medicine2026-06-11

Letter to the Editor: Impact of the intensivist at the bedside - the case of rational use of benzodiazepines.

Nedel Wagner W

The detrimental effects associated with prolonged benzodiazepine infusion have long been recognized, and precipitated a transformation in the management of sedation and analgesia in critically ill patients. This transformation emphasizes the need to reduce the continuous use of benzodiazepines. Achieving an appropriate sedo-analgesia target tailored to the patient's context requires clinical staff to possess knowledge and considerable experience in this management. The study published in World Journal of Critical Care Medicine by Nestoiter et al exemplified this scenario. The authors identified an association between the continuous use of midazolam and the absence of a critical care team managing patients at the bedside. The use of continuous midazolam, as an indicator of good clinical practice, was associated with unfavorable clinical outcomes, such as increased days in coma and delirium. These results reinforce the fact that effective management of sedation and analgesia is a critical area where the fundamental role of the intensivist in the care of critically ill patients is evident. These findings should not be interpreted in isolation but rather within a set of organizational aspects that characterize a high-performing intensive care unit, such as an adequate patient-to-nurse ratio, the presence of an intensivist-led team, and the development of clinical protocols in sedation and analgesia management.

PMID 42272877
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