Korean J Anesthesiol.  2013 Jul;65(1):9-13. 10.4097/kjae.2013.65.1.9.

The effect of midazolam dose and age on the paradoxical midazolam reaction in Korean pediatric patients

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. myungsmc@yahoo.co.kr

Abstract

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.

Keyword

Child; Midazolam; Paradoxical reaction

MeSH Terms

Anxiety
Child
Crying
Humans
Incidence
Midazolam
Risk Factors
Weights and Measures
Midazolam

Cited by  2 articles

Paradoxical reaction to midazolam in children
Young Eun Moon
Korean J Anesthesiol. 2013;65(1):2-3.    doi: 10.4097/kjae.2013.65.1.2.

Assessment of P values for demographic data in randomized controlled trials
Eun Jin Ahn, Jong Hae Kim, Tae Kyun Kim, Jae Hong Park, Dong Kyu Lee, Sangseok Lee, Junyong In, Hyun Kang
Korean J Anesthesiol. 2019;72(2):130-134.    doi: 10.4097/kja.d.18.00333.

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