New Benzodiazepines
The primary limitation of midazolam, which is the best suited
benzodiazepine for use in anesthesia, is its slightly slower onset and prolonged
offset when compared with a hypnotic such as propofol. Other benzodiazepine agonists
have been used in clinical trials, but it is unlikely that
they will undergo further development. The most welcome new benzodiazepine would
be one rapidly metabolized by esterases, as seen with remifentanil, for faster onset
and shorter duration. With discovery of the GABAA
subtypes, it is also
possible that new specific drugs will be developed to provide certain agonist actions
that are devoid of some of the undesirable side effects such as respiratory depression.
