Which CNS effect is observed with midazolam at induction dose?

Which CNS effect is observed with midazolam at induction dose?

• A. Decreased CMRO2 and CBF
• B. Increased CMRO2
• C. Isoelectric EEG
• D. Analgesia

Answer: (A)

Midazolam produces CNS depression by potentiating GABA-A receptor activity, which lowers neuronal firing and overall brain activity. This reduced neuronal activity lowers the brain’s metabolic demand for oxygen (CMRO2). Because cerebral blood flow (CBF) is tightly linked to metabolic demand, a drop in CMRO2 leads to a corresponding decrease in CBF. So at induction doses the observed CNS effect is decreased CMRO2 and CBF. It doesn’t increase metabolic demand, nor does it typically produce an isoelectric EEG at this dose; and while it causes sedation and amnesia, it doesn’t provide meaningful analgesia.

Midazolam produces CNS depression by potentiating GABA-A receptor activity, which lowers neuronal firing and overall brain activity. This reduced neuronal activity lowers the brain’s metabolic demand for oxygen (CMRO2). Because cerebral blood flow (CBF) is tightly linked to metabolic demand, a drop in CMRO2 leads to a corresponding decrease in CBF. So at induction doses the observed CNS effect is decreased CMRO2 and CBF. It doesn’t increase metabolic demand, nor does it typically produce an isoelectric EEG at this dose; and while it causes sedation and amnesia, it doesn’t provide meaningful analgesia.