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The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients
BACKGROUND: Although midazolam administration may occasionally induce a paradoxical episode, such as threatened crying and violent behavior in children, systematic studies on the causes of paradoxical reaction are limited. We investigated the effect of children's age and a dose of midazolam on...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Anesthesiologists
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726857/ https://www.ncbi.nlm.nih.gov/pubmed/23904933 http://dx.doi.org/10.4097/kjae.2013.65.1.9 |
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author | Shin, Young Hee Kim, Myung Hee Lee, Jung Jin Choi, Soo Joo Gwak, Mi Sook Lee, Ae Ryoung Park, Mi Na Joo, Hyo Sung Choi, Jung Hee |
author_facet | Shin, Young Hee Kim, Myung Hee Lee, Jung Jin Choi, Soo Joo Gwak, Mi Sook Lee, Ae Ryoung Park, Mi Na Joo, Hyo Sung Choi, Jung Hee |
author_sort | Shin, Young Hee |
collection | PubMed |
description | BACKGROUND: Although midazolam administration may occasionally induce a paradoxical episode, such as threatened crying and violent behavior in children, systematic studies on the causes of paradoxical reaction are limited. We investigated the effect of children's age and a dose of midazolam on the paradoxical reaction. METHODS: A total of one hundred sixty four children of 1-3 years and 3-5 years, were enrolled in this study. Each age group randomly received 0.05 mg/kg or 0.1 mg/kg of intravenous midazolam (41 patients/group). RESULTS: The incidence of paradoxical midazolam reaction in the study groups, 1-3 years with 0.1 mg/kg of intravenous midazolam, 1-3 years with 0.05 mg/kg, 3-5 years with 0.1 mg/kg, and 3-5 years with 0.05 mg/kg were as follows: 29.3%, 12.2%, 7.3% and 2.4%, respectively. The incidence among the 4 groups was significantly different (P = 0.002), highest in the 1-3 years receiving 0.1 mg/kg of midazolam (29.3%). Both age (P = 0.004, OR [95%CI] = 5.3 [1.7-16.8]) and dose of midazolam (P = 0.036, OR [95%CI] = 3.0 [1.1-8.4]) were risk factors. Perioperative clinical data including anxiety scales of children were not associated with the paradoxical midazolam reaction. CONCLUSIONS: In conclusion, we suggest that children less than 3 years old receiving higher dose of intravenous midazolam are at risk for the paradoxical midazolam reaction. |
format | Online Article Text |
id | pubmed-3726857 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | The Korean Society of Anesthesiologists |
record_format | MEDLINE/PubMed |
spelling | pubmed-37268572013-07-31 The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients Shin, Young Hee Kim, Myung Hee Lee, Jung Jin Choi, Soo Joo Gwak, Mi Sook Lee, Ae Ryoung Park, Mi Na Joo, Hyo Sung Choi, Jung Hee Korean J Anesthesiol Clinical Research Article BACKGROUND: Although midazolam administration may occasionally induce a paradoxical episode, such as threatened crying and violent behavior in children, systematic studies on the causes of paradoxical reaction are limited. We investigated the effect of children's age and a dose of midazolam on the paradoxical reaction. METHODS: A total of one hundred sixty four children of 1-3 years and 3-5 years, were enrolled in this study. Each age group randomly received 0.05 mg/kg or 0.1 mg/kg of intravenous midazolam (41 patients/group). RESULTS: The incidence of paradoxical midazolam reaction in the study groups, 1-3 years with 0.1 mg/kg of intravenous midazolam, 1-3 years with 0.05 mg/kg, 3-5 years with 0.1 mg/kg, and 3-5 years with 0.05 mg/kg were as follows: 29.3%, 12.2%, 7.3% and 2.4%, respectively. The incidence among the 4 groups was significantly different (P = 0.002), highest in the 1-3 years receiving 0.1 mg/kg of midazolam (29.3%). Both age (P = 0.004, OR [95%CI] = 5.3 [1.7-16.8]) and dose of midazolam (P = 0.036, OR [95%CI] = 3.0 [1.1-8.4]) were risk factors. Perioperative clinical data including anxiety scales of children were not associated with the paradoxical midazolam reaction. CONCLUSIONS: In conclusion, we suggest that children less than 3 years old receiving higher dose of intravenous midazolam are at risk for the paradoxical midazolam reaction. The Korean Society of Anesthesiologists 2013-07 2013-07-19 /pmc/articles/PMC3726857/ /pubmed/23904933 http://dx.doi.org/10.4097/kjae.2013.65.1.9 Text en Copyright © the Korean Society of Anesthesiologists, 2013 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Research Article Shin, Young Hee Kim, Myung Hee Lee, Jung Jin Choi, Soo Joo Gwak, Mi Sook Lee, Ae Ryoung Park, Mi Na Joo, Hyo Sung Choi, Jung Hee The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients |
title | The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients |
title_full | The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients |
title_fullStr | The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients |
title_full_unstemmed | The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients |
title_short | The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients |
title_sort | effect of midazolam dose and age on the paradoxical midazolam reaction in korean pediatric patients |
topic | Clinical Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726857/ https://www.ncbi.nlm.nih.gov/pubmed/23904933 http://dx.doi.org/10.4097/kjae.2013.65.1.9 |
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