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Massive doses of midazolam infusion for delirium tremens without respiratory depression
W C Lineaweaver1, K Anderson, D N Hing
1Microsurgical Replantation Transplantation Department, Ralph K. Davies Medical Center, San Francisco, CA 94114.
Abstract:
After undergoing replantation and revascularization surgery for a complex hand injury, a 25-yr-old male developed florid delirium tremens. Over a 5-day period, he received 2850 mg of midazolam as a constant infusion of varying rates. The midazolam controlled his severe agitation without respiratory depression and the hand reconstruction survived undamaged.
Insights
A young man experienced severe agitation (delirium tremens) after hand surgery. Continuous midazolam infusion effectively managed his symptoms without causing breathing problems, preserving his reconstructed hand.
Area of Science:
- Trauma surgery
- Anesthesiology
- Intensive care medicine
Background:
- Replantation and revascularization are critical for complex hand injuries.
- Postoperative delirium tremens can complicate recovery.
- Sedation management is essential for patient stability and surgical success.
Observation:
- A 25-year-old male developed severe agitation (delirium tremens) post-hand surgery.
- Midazolam was administered as a continuous infusion over five days.
- The infusion rate varied to manage agitation.
Findings:
- A total of 2850 mg of midazolam was administered.
- Continuous midazolam infusion effectively controlled severe agitation.
- No respiratory depression occurred during midazolam administration.
Implications:
- Continuous midazolam infusion is a viable option for managing delirium tremens in surgical patients.
- This approach can ensure patient comfort and safety without compromising respiratory function.
- Successful management facilitated the survival of the complex hand reconstruction.