Effects of midazolam on directly stimulated muscle biopsies from control and malignant hyperthermia positive patients.

Midazolam is a water soluble benzodiazepine of interest to the anaesthetist for use as a premedicant and for induction of anaesthesia. The effects of midazolam were observed on the resting tension of directly stimulated muscle biopsied from control and malignant hyperthermia (MH) susceptible patients. In addition, interactions between midazolam and the two most commonly used MH diagnostic agents (halothane and caffeine) were examined. Midazolam, at maximum therapeutic concentrations (ca. 0.5 microgram X ml-1), had no detectable effects on muscle contraction in preparations from control or MH positive patients. Midazolam did elicit a contracture from control and MH positive preparations when used in a concentration range of 160-1280 micrograms X ml-1. There was no significant difference between control and MH positive patients in minimum concentration of midazolam causing contracture or the strength of contracture at the respective eliciting concentration. There appears to be no interaction between midazolam and either halothane or caffeine on the resting tension of the directly stimulated muscle twitch preparation.