A prospective study of the adverse effects of midazolam on withdrawal in critically ill children.

Abstract

Fifty-three critically ill infants and children received midazolam as sedation in a regional intensive care unit. Assessment of the level of sedation was carried out at regular intervals on withdrawal of midazolam. Forty-nine patients were fully alert within 4 h of midazolam being stopped. Four patients took from 6 h to 1 week to become fully alert. Four patients had abnormal behaviour highly suggestive of midazolam withdrawal. The onset of abnormal behaviour was within 12 h of discontinuation of midazolam. The duration of the abnormal behaviour ranged from 3 h to 1 week. One child had a paradoxical reaction to midazolam. The overall incidence of adverse effects to midazolam in the patients studied was 17%. No adverse effects were observed in infants; all adverse effects were observed in children. We have shown that it is possible to prospectively study the toxicity of sedatives in critically ill infants and children.

• Authors: J Hughes, A Gill, H J Leach, A J Nunn, I Billingham, J Ratcliffe, R Thornington, I Choonara
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 83 Issue 11 Pg. 1194-9 (Nov 1994) ISSN: 0803-5253 [Print] Norway
• PMID: 7841736 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Midazolam

Topics

• Child
• Child Behavior (drug effects)
• Child, Preschool
• Critical Illness (therapy)
• Hallucinations (chemically induced)
• Humans
• Incidence
• Infant
• Infant, Newborn
• Midazolam (adverse effects)
• Neurologic Examination
• Prospective Studies
• Risk Factors
• Sleep Stages (drug effects)
• Substance Withdrawal Syndrome (diagnosis, etiology)