J Korean Dent Soc Anesthesiol.  2009 Jun;9(1):30-35. 10.17245/jkdsa.2009.9.1.30.

Paradoxical Reactions following Intravenous Midazolam in Patients with Severe Anxiety for Dental Treatment: A Case Report

• O SR

• KMID: 2345109
• DOI: http://doi.org/10.17245/jkdsa.2009.9.1.30

Abstract

Intravenous midazolam has been frequently used for the relief of anxiety in dental treatment. This is likely the result of the sedative and anterograde amnestic properties of midazolam that are mediated through γ-Aminobutyric acid agonism. Unfortunately, Paradoxical reactions to midazolam include agitation, talkativeness, confusion, disinhibition, aggression,violent behavior, act of self-injury and need for restraints. These occur in less than 1% of all patients receiving midazolam,may occur at variable times after administration and are difficult to predict and diagnose. Two women with severe anxiety for dental treatment experienced paradoxical reactions associated with the use of intravenous midazolam. We are reviewed the management and prevention of paradoxical reactions and its different etiology.

Keyword

Intravenous midazolam; Paradoxical reactions

MeSH Terms

Anxiety*
Dihydroergotamine
Felodipine
Female
Humans
Midazolam*
Dihydroergotamine
Felodipine
Midazolam