TY - JOUR ID - 251198 TI - Paradoxical Reaction to Hypnotics in Intensive Care Unit JO - TANAFFOS (Respiration) JA - RSPR LA - en SN - 1735-0344 AU - Mottard, Nicolas AU - Boulay, Guillaume AU - Hautin, Etienne AD - Department of Anesthesiology and Critical Care, Clinique de la Sauvegarde, Ramsay Santé, Lyon, France Y1 - 2021 PY - 2021 VL - 20 IS - 3 SP - 284 EP - 286 KW - Hypnotics KW - Paradoxical reactions KW - Intensive care unit DO - N2 - Background: Paradoxical reactions (PR) to benzodiazepines are well-known, but PR can also follow sedation by propofol, although this has been reported only in the context of operating room anesthesia. We report a rare case of paradoxical excitement induced by midazolam and propofol. Case presentation: A 78-year-old patient presented with multiorgan failure secondary to infectious pneumopathy. During intensive care unit (ICU) stay, he experienced 2 episodes of ventilator-acquired pneumonia and 1 of acute kidney failure requiring renal replacement therapy. Throughout the stay, he showed restlessness, uncontrollable muscle spasms and stiffness without any neurological focus. Paradoxical reaction to midazolam and to propofol was diagnosed; difficult withdrawal was followed by favorable progression. Conclusion: PR in the ICU context is exceptional. The present case is unique, with severe PR not only to midazolam but also to propofol. This etiology, with difficult withdrawal, should be considered after ruling out all classical etiologies for refractory agitation. UR - https://www.tanaffosjournal.ir/article_251198.html L1 - https://www.tanaffosjournal.ir/article_251198_bcf8bb9ba0528f6bc9632ccb2acbbbdd.pdf ER -