Paradoxical reactions in children associated with midazolam use during endoscopy.

Journal Article (Journal Article)

All 2,617 children who received midazolam and meperidine for a variety of endoscopic procedures were monitored for the development of adverse behavioral problems. Thirty-six (1.4%) of the children (ages 1-17 years) experienced a paradoxical behavioral reaction, which consisted of inconsolable crying, combativeness, disorientation, dysphoria, tachycardia, agitation, and restlessness. The reaction occurred at a mean of 17 minutes after the administration of midazolam. Following treatment with flumazenil, the reaction dissipated within a mean of 14 minutes. Three of the 36 patients underwent additional endoscopic procedures utilizing only meperidine. No similar reaction was observed in these patients. Awareness of the reaction and prompt administration of flumazenil decreased the duration of the reaction.

Full Text

Duke Authors

Cited Authors

  • Massanari, M; Novitsky, J; Reinstein, LJ

Published Date

  • December 1997

Published In

Volume / Issue

  • 36 / 12

Start / End Page

  • 681 - 684

PubMed ID

  • 9415834

International Standard Serial Number (ISSN)

  • 0009-9228

Digital Object Identifier (DOI)

  • 10.1177/000992289703601202


  • eng

Conference Location

  • United States