What is the one medication commonly used as a preoperative anxiolytic?

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

Answer: (A)

Midazolam is preferred for preoperative anxiolysis because it acts quickly to calm nerves and provides amnesia without prolonged sedation. When given IV, its onset is rapid, and its effects wear off relatively soon, allowing the patient to recover promptly after anesthesia induction. As a benzodiazepine, it enhances GABA activity at the GABA-A receptor, giving fast anxiolysis, sedation, and anterograde amnesia—exactly what helps patients tolerate the preop environment and procedures. Other benzodiazepines tend to have longer durations or slower onsets, making them less ideal for the short, single-dose needs of preop use. Safety considerations include monitoring for respiratory depression and airway protection, with reversal possible with flumazenil if necessary.