2025, Vol. 8, Issue 2, Part B

Method: A total of 30 patients (aged 61-93 years and in American Society of Anesthesiologists classification 1, 2, and 3) who were scheduled for lower extremity surgery and exhibited elevated blood pressure prior to anesthesia were divided into two groups. Group 1 (n = 15) comprised patients who had a history of antihypertensive medication use, while Group 2 (n = 15) did not have a history of hypertension. The following parameters were monitored: blood pressure and pulse. These were assessed at 8:00 a.m. on the day of surgery, upon arrival in the operating room, and at 5, 10, and 15 minutes prior to anesthesia. Intravenous midazolam was administered at a rate of 0.01 mg/kg every 5 minutes until blood pressure decreased to 140/90 mmHg or until spontaneous eye closure.

Results: The doses of midazolam administered were 1.7 mg for group 1, 1.2 mg for group 2, and 1.5 mg for elderly patients (equivalent to 0.03 mg/kg). The sedation level was classified as between Ramsey scales 3 and 4. It is noteworthy that age significantly impacts the determination of the optimal dosage of the pharmaceutical agent. Upon arrival in the operation room, significant elevations in blood pressure were observed; however, these readings diminished to the level recorded at 8 a.m. on the day of the operation 15 minutes after the midazolam injection.

Conclusion: For elderly individuals, the dosage of midazolam is approximately one-third to one-quarter of the dosage administered to young, healthy individuals. In older individuals, the administration of low doses of midazolam has been shown to promote cardiovascular stability and anxiolytic effects.