Paradoxical Reaction to Midazolam Reversed with Flumazenil in a Patient Undergoing Tumescent Liposuction

Heller, Marissa; Hayes, Christine; Krejci, Niels C.

doi:10.1111/j.1524-4725.2009.01204.x

Cited by 9 publications

(2 citation statements)

References 11 publications

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“…While we did not experience any unwanted effects of diazepam, it has been shown that midazolam may occasionally precipitate hostility and violence instead of tranquility. These symptoms can be reversed with flumazenil [11]. Guidelines of care for liposuction need to be followed meticulously, and for the few patients needing further attention in an outpatient setting, a response system needs to be put in place where potential complications can be addressed immediately.…”

Section: Discussionmentioning

confidence: 99%

Safety of Tumescent Liposuction under Local Anesthesia in a Series of 4,380 Patients

Boeni¹

2011

Dermatology

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Background: Liposuction is increasingly performed under local anesthesia and in an outpatient setting. The term ‘tumescent liposuction’ has been used in the literature in patients receiving other forms of anesthesia as well, hence the confusion regarding the safety profile of liposuction performed under local anesthesia alone. Objective: To analyze the safety of tumescent liposuction performed under local anesthesia in a larger group of patients. Methods: Between 2003 and 2010, 4,380 consecutive patients underwent tumescent liposuction by the same surgeon. The occurrence of complications was recorded in detail. Results: There were no serious complications requiring hospitalization. There were no injuries, no nerve damage or permanent lymphedema, no deep venous thrombosis or seroma. Seven patients needed closer follow-up due to large hematoma (n = 3; no drainage needed), allergic drug reaction to doxycycline (n = 2), erysipelas (n = 1) and generalized edema (n = 1). Conclusions: Tumescent liposuction under local anesthesia is a safe method, providing it is performed by an experienced surgeon and the guidelines of care for liposuction are strictly followed.

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Section: Discussionmentioning

confidence: 99%

Safety of Tumescent Liposuction under Local Anesthesia in a Series of 4,380 Patients

Boeni¹

2011

Dermatology

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“…1 However, in about 1% of the population, benzodiazepines have demonstrated a paradoxical reaction. 2 This paradoxical reaction has been described to manifest as restlessness, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] aggression [18][19][20][21][22][23][24][25][26][27][28][29] and sexual disinhibition. 30,31 The pathophysiologic mechanism of these reactions is unknown, although authors have postulated differing theories and several predisposing risk factors have been identified including young or advanced age, history of alcohol abuse, baseline poor impulse control, and genetic predisposition.…”

Section: Introductionmentioning

confidence: 99%

Paradoxical Excitation Following Intravenous Lorazepam Administration for Alcohol Withdrawal – A Case Presentation and Literature Review

Gonzalez

Upadhyaya

Manna

et al. 2022

Journal of Pharmacy Practice

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Benzodiazepines are commonly used medications which are clinically useful towards the treatment of alcohol withdrawal, seizures, anxiety disorders, among other indications. Benzodiazepine use is also known to cause the rare phenomenon of paradoxical excitation whose mechanism has many postulated theories. We report this rare presentation of paradoxical excitation with the use of lorazepam in a 50-year-old male being treated for alcohol withdrawal. We also review the underlying pathophysiology, pharmacology, and current literature as it relates to this excitation. An inability to recognize this adverse effect and to appropriately withhold the agent may adversely affect a patient’s course of treatment in the inpatient setting.

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Current awareness: Pharmacoepidemiology and drug safety

2009

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Paradoxical Reaction to Midazolam Reversed with Flumazenil in a Patient Undergoing Tumescent Liposuction

Cited by 9 publications

References 11 publications

Safety of Tumescent Liposuction under Local Anesthesia in a Series of 4,380 Patients

Safety of Tumescent Liposuction under Local Anesthesia in a Series of 4,380 Patients

Paradoxical Excitation Following Intravenous Lorazepam Administration for Alcohol Withdrawal – A Case Presentation and Literature Review

Current awareness: Pharmacoepidemiology and drug safety

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