Midazolam is sometimes used as a sedating drip when other sedating drips aren’t working as an effective calming agent for folks on vents. It’s never a first line agent...at least in the USA. Fentanyl and propofol are used more often because they metabolize quickly when turned off, though propofol causes issues with triglycerides if used in a prolong period and the anesthetic can have some blunting issues with the nervous system when used too long. Often we will stop propofol first and increase the Fentanyl analgesic and add precedex then titrate the drips to a Ras_1(awakens when name called, follows commands then goes back to a light sleep).
The folks with heavy alcohol and drug histories often need the stronger stuff, especially when they have been heavy drug users or drinkers who have been using just prior to admission as these folks will go into withdrawal. I’ve seen dilaudid drips , midazolam, propofol, and Nimbex(paralyzing med being used) all at the same time. No, most of them didn’t die because they got a wiff of midazolam(versed) OR Remdesivir!