Background and aims: Intra operative awareness is one of the unpleasant complications of anesthesia. This complication must be decreased because of psychological and physiological consequences. This study was aimed aims to determine the effect of midazolam on reducing intra-operative awareness during general anesthesia. Methods: This double-blind clinical trial study was conducted on 154 patients candidate for elective surgery, 15-45 years old, in class I or II of American Society of Anesthesiologists )ASA), with mean surgery duration of an hour, no hearing problem, history of neurological illness, or taking effective medications in psychological and neurological terms were assigned randomly into two groups: intervention group receiving intravenous midazolam (2.5 mg/l), for general anesthesia 15 minutes prior to operation, and control group. Necessity to increase depth of anesthesia or sedative use and post operative symptom was analyzed. Data were analyzed using SPSS and K2. Results: The symptoms of intraoperative awareness including lacrimation, requiring additional analgesia, and increased depth of anesthesia as well as post operative symptoms in terms of comfortable feeling in recovery were significantly lower in the intervention group compared to the control. Conclusion: Regarding the findings of the present study midazolam used as a premedication is effective on reducing the complications resulted from awareness during general anesthesia
