Which benzodiazepine is most commonly used for preoperative anxiety and moderate sedation?

• A. Midazolam
• B. Diazepam
• C. Alprazolam
• D. Lorazepam

Answer: (A)

Midazolam is favored for preoperative anxiety and moderate sedation because its pharmacokinetic profile fits short procedures well. When given by IV, it acts quickly to reduce anxiety and provide sedation with anterograde amnesia, and its effects are relatively short-lived, allowing for a smoother and quicker recovery. It’s also easily titratable and has minimal active metabolites, which helps minimize prolonged sedation. If needed, its effects can be reversed with flumazenil for added safety. Other benzodiazepines tend to linger longer or have slower onset and metabolism that make them less suitable for outpatient procedural use—diazepam has a long half-life with active metabolites, lorazepam carries accumulation risks, and alprazolam is not typically used for procedural sedation due to slower, less predictable onset.