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A prospective study of the adverse effects of midazolam on withdrawal in critically ill children
Author(s) -
Hughes J.,
Gill A.,
Leach HJ,
Nunn AJ,
Billingham I.,
Ratcliffe J.,
Thornington R.,
Choonara I.
Publication year - 1994
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1994.tb18280.x
Subject(s) - midazolam , medicine , discontinuation , sedation , critically ill , anesthesia , adverse effect , intensive care unit , incidence (geometry) , prospective cohort study , pediatrics , intensive care medicine , surgery , physics , optics
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.