Electroencephalographic effects of benzodiazepines. I. Choosing an electroencephalographic parameter to measure the effect of midazolam on the central nervous system

The goal of this investigation was to determine a numerical electroencephalographic parameter that best indicated the degree of the effect of midazolam, administered in hypnotic doses, on the central nervous system. This electroencephalographic parameter could then be used to relate midazolam plasma concentrations and electroencephalographic drug effect (pharmacodynamic modeling). Intravenous doses of midazolam (3.75 to 25 mg) were given to five men at an infusion rate of 5 mg/min. A cortical electroencephalogram was continuously recorded. Two waveform analysis approaches were examined: fast Fourier transformation and aperiodic analysis. From fast Fourier transformation and aperiodic analysis a set of parameters were examined as measures of drug effect. We conclude that the voltage per second from aperiodic analysis provided the electroencephalographic parameter that optimally measured the effect of midazolam on the central nervous system.