Amnesia and sensation disorders induced by the combination of midazolam and fentanyl
10.3760/cma.j.cn114015-20240926-00062
- VernacularTitle:咪达唑仑联合芬太尼致遗忘和感觉障碍
- Author:
Rongchun WANG
1
;
Na LI
1
;
Jia TIAN
1
;
Xiangbo ZENG
1
Author Information
1. 湖南省第二人民医院（湖南省脑科医院）呼吸与危重症医学科，长沙 410011
- Publication Type:Journal Article
- Keywords:
Amnesia;
Sensation disorders;
Midazolam;
Fentanyl;
Disorientation;
Respiratory insufficiency
- From:
Adverse Drug Reactions Journal
2025;27(7):443-445
- CountryChina
- Language:Chinese
-
Abstract:
A 62-year-old female patient underwent medical thoracoscopic pleural biopsy for undiagnosed pleural effusion. Preoperative vital signs in the patient were stable, with no cardiovascular, cerebrovascular or neurological underlying diseases. During the procedure, midazolam 2 mg (0.045 mg/kg) and fentanyl 150 μg (3.3 μg/kg) were administered by intravenous injection for sedation and analgesia. Two minutes later, the patient developed respiratory depression, and her oxygen saturation decreased to 42%. Immediate jaw thrust maneuver followed by bag-valve-mask ventilation was initiated, and the spontaneous respiration resumed and oxygen saturation recovered (>90%) after 2 minutes, allowing successful biopsy of a pleural nodule. The patient was fully conscious in the immediate postoperative period, with normal ability of communication and mobility. However, at 6 hours postoperatively, she developed anterograde and retrograde amnesia, disorientation, sensation disorders, nausea, and retching. Cranial magnetic resonance imaging revealed no significant abnormalities. These symptoms were considered to be related to transient higher cortical dysfunction induced by the sedative and analgesic agents. Given supportive treatments including fluid administration, the symptoms were gradually improved at 8 hours postoperatively, and resolved completely by 11 hours postoperatively.
