Reversal of midazolam-induced laryngospasm with flumazenil.

Abstract

Midazolam is a commonly used benzodiazepine that is ideal for conscious sedation during a variety of procedures. Laryngospasm is listed by the manufacturer as a rare side effect of midazolam. Flumazenil is a competitive inhibitor of the benzodiazepines that is available for reversal at the end of such a procedure or when too much sedation has been achieved. We present a case of a 61-year-old man who was to undergo conscious sedation before cardioversion. Shortly after receiving midazolam, he developed laryngospasm and resultant respiratory distress; the laryngospasm was reversed by a small dose of flumazenil. The symptoms recurred after approximately 25 minutes and were again reversed with flumazenil. Neither midazolam-induced laryngospasm nor its reversal with flumazenil have previously been reported. A brief discussion regarding laryngospasm and the use of flumazenil are included.

• Authors: D P Davis, R S Hamilton, T H Webster
• Journal: Annals of emergency medicine (Ann Emerg Med) Vol. 32 Issue 2 Pg. 263-5 (Aug 1998) ISSN: 0196-0644 [Print] United States
• PMID: 9701315 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Anti-Anxiety Agents
• Antidotes
• GABA Modulators
• Hypnotics and Sedatives
• Flumazenil
• Midazolam

Topics

• Anti-Anxiety Agents (adverse effects, antagonists & inhibitors)
• Antidotes (administration & dosage, therapeutic use)
• Conscious Sedation (adverse effects)
• Electric Countershock
• Flumazenil (administration & dosage, therapeutic use)
• GABA Modulators (administration & dosage, therapeutic use)
• Humans
• Hypnotics and Sedatives (adverse effects, antagonists & inhibitors)
• Laryngismus (chemically induced, drug therapy)
• Male
• Midazolam (adverse effects, antagonists & inhibitors)
• Middle Aged
• Recurrence
• Respiratory Insufficiency (chemically induced, drug therapy)
• Retreatment