Intranasal flumazenil and naloxone to reverse over-sedation in a child undergoing dental restorations

Paediatr Anaesth. 2009 Aug;19(8):795-7; discussion 798-9. doi: 10.1111/j.1460-9592.2009.03069_1.x.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage
  • Adjuvants, Anesthesia / antagonists & inhibitors
  • Administration, Intranasal
  • Anesthesia, Dental / adverse effects*
  • Antidotes / administration & dosage*
  • Child, Preschool
  • Dental Restoration, Temporary
  • Female
  • Flumazenil / administration & dosage*
  • Humans
  • Laryngismus / etiology
  • Laryngismus / therapy
  • Midazolam / administration & dosage
  • Midazolam / antagonists & inhibitors
  • Naloxone / administration & dosage*
  • Narcotic Antagonists / administration & dosage*
  • Oxygen / blood
  • Sufentanil / administration & dosage
  • Sufentanil / antagonists & inhibitors
  • Treatment Outcome

Substances

  • Adjuvants, Anesthesia
  • Antidotes
  • Narcotic Antagonists
  • Naloxone
  • Flumazenil
  • Sufentanil
  • Midazolam
  • Oxygen