Related Experiment Videos
Myoclonus associated with lorazepam therapy in very-low-birth-weight infants
D S Lee1, H A Wong, D C Knoppert
1Department of Paediatrics, St. Joseph's Health Centre, Lawson Research Institute, University of Western Ontario, London, Canada.
Insights
Lorazepam is increasingly used for sedation in newborns, but may cause myoclonus in very-low-birth-weight infants. Caution is advised when administering injectable lorazepam to these vulnerable infants.
Area of Science:
- Neonatal pharmacology
- Pediatric neurology
- Clinical toxicology
Background:
- Lorazepam is frequently administered as a sedative to neonates and young infants.
- Increasing use raises concerns about the drug's safety profile in this population.
- Particular attention is needed for very-low-birth-weight (VLBW) infants (< 1,500 g).
Observation:
- Three VLBW infants (< 1,500 g) developed myoclonus after intravenous lorazepam.
- Myoclonus is characterized by sudden, involuntary muscle jerks.
- This adverse event occurred in a vulnerable neonatal subgroup.
Findings:
- Intravenous lorazepam administration was associated with myoclonus in VLBW infants.
- The study highlights potential neurotoxic effects of lorazepam and its vehicle.
- This suggests a specific risk in extremely preterm or low-birth-weight neonates.
Implications:
- Injectable lorazepam should be used with significant caution in VLBW infants.
- Further research into lorazepam's neurotoxicity in neonates is warranted.
- Clinical practice guidelines may need revision regarding lorazepam use in VLBW infants.
Abstract:
Lorazepam is being used with increasing frequency as a sedative in the newborn and the young infant. Concern has been raised with regard to the safety of lorazepam in this age group, especially in very-low-birth-weight (VLBW; < 1,500 g) infants. Three young infants, all of birth weight < 1,500 g, experienced myoclonus following the intravenous administration of lorazepam. The potential neurotoxic effects of the drug (and its vehicle) in this population are discussed. Injectable lorazepam should be used with caution in VLBW infants.