Anesthesiology and Intensive Care

  Midazolam , a benzodiazepine, is currently the drug most commonly used to  reduce preoperative anxiety and induce sedation. It can be administered intravenously and orally. In adults, it can be used to control preoperative anxiety and, during a procedure alone or in combination with other drugs, for intravenous sedation . For children, oral midazolam in doses as small as 0.25 mg/kg

         The muscarinic antagonists compete with neurally released acetylcholine ( ACh )   for access to muscarinic cholinoceptors and block  ACh’s  effects. The results are faster heart rate, sedation,  and dry mouth. With the exception of the quaternary  ammonium compounds that do not readily cross the  blood-brain barrier and have few actions on the CNS,  there is no significant specificity of action among these drugs; they block all muscarinic effects with equal efficacy, although there are some quantitative differences in effect.