Intranasal flumazenil and naloxone to reverse over-sedation in a child undergoing dental restorations.
We describe a 3-year-old child who became over-sedated after receiving intranasal (IN) midazolam (0.53 mg.kg(-1)) and IN sufentanil (1 mcg.kg(-1)) for dental restorations in the dental office. Desaturation was attributed to laryngospasm, which was managed with positive pressure ventilation and oxygen. The sedation was reversed with a combination of IN flumazenil and naloxone.
Heard
Christopher
C
Department of Pediatric Anesthesiology, Women & Children's Hospital of Buffalo, Buffalo, NY 14222, USA.
Creighton
Paul
P
Lerman
Jerrold
J
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D000281:Administration, Intranasal; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000931:Antidotes / Q000008:administration & dosage*; D002675:Child, Preschool; D003794:Dental Restoration, Temporary; D005260:Female; D005442:Flumazenil / Q000008:administration & dosage*; D006801:Humans; D007826:Laryngismus / Q000209:etiology / Q000628:therapy; D008874:Midazolam / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D010100:Oxygen / Q000097:blood; D017409:Sufentanil / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
D000759:Adjuvants, Anesthesia; D000931:Antidotes; D009292:Narcotic Antagonists; D009270:Naloxone; D005442:Flumazenil; D017409:Sufentanil; D008874:Midazolam; D010100:Oxygen