Title: Treatment Of Midazolam-Induced Paradoxical Reactions
题目：处理咪达唑仑诱导的反常反应
Author (作者)：EMedHome.com
翻译：陈都 校对：肖锋

A recent Question of the Day asked about the use of flumazenil to reverse midazolam-induced paradoxical reactions in children. The Question generated a lot of interest, so we are using this week's Clinical Pearl to expand upon the subject.
最近的每日一题涉及到儿童中使用氟马西尼逆转咪达唑仑诱导的反常反应。这个问题很有趣，所以我们通过本周的临床必知对这个问题进行展开讨论。

Midazolam s commonly used for pediatric anxiolysis and sedation in the ED. Paradoxical reactions to midazolam occur idiosyncratically. Clinical manifestations include agitation, confusion, delirium, inconsolable hysteria, aggression, and restlessness. Such paradoxical reactions have been reported after oral as well as IV midazolam.
咪达唑仑广泛应用于儿科急诊的抗焦虑和镇静治疗。对咪达唑仑的反常反应异乎寻常。临床表现包括焦虑、困惑、精神错乱, 无法控制的歇斯底里, 侵略性, 坐立不安。有报道显示这种异常反应可以发生在口服及静脉使用咪达唑仑之后。

Paradoxical reactions to benzodiazepines are often intense and may require pharmacologic treatment. A clinician may incorrectly assume that the patient's agitation should be treated with more midazolam. This post-midazolam symptomatology should accurately be diagnosed as a paradoxical reaction and the clinician should consider treatment with flumazenil.
对苯二氮卓类药物的异常反应往往比较激烈从而需要药物治疗。临床医生可能会误判，认为患者的躁动需要使用更多的咪达唑仑。此类使用咪达唑仑后的症候群应该被正确诊断为异常反应，从而使用氟马西尼进行治疗。