The use of midazolam and flumazenil in diagnostic and short surgical procedures

Acta Anaesthesiologica Scandinavica. Supplementum
J G Whitwam

Abstract

Benzodiazepines, used correctly, provide a relatively safe means of providing sedation in a variety of clinical situations and midazolam, which is shorter acting than other benzodiazepines (BZ), is the drug of choice in ambulatory patients. Flumazenil is a highly effective specific competitive BZ antagonist which provides a safe means of rapidly attenuating or terminating BZ sedation. Its mean half-life is 54 min, and in this contact the optimal dosage is 0.2 to 0.5 mg. Although it reverses sedation and amnesia, there is still a question about whether its efficacy in reversing the respiratory depressant effects of benzodiazepines is adequate. This remains an area of critical debate, as does resedation and also its administration to chronic benzodiazepine users. The use of flumazenil to reverse midazolam-induced sedation introduces, for the first time, the possibility of terminating sedation at a predetermined time. Were it to be adopted routinely, it has major implications for the improvement of patient management affecting all aspects of post-operative care.

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Citations

Jun 26, 2014·Brain Sciences·Lisa Wise-FaberowskiGregory B Hammer
Feb 25, 2014·Digestive Diseases and Sciences·Elisabeth M H Mathus-VliegenHedwig A Kos-Foekema
Apr 16, 2010·Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine·Kirsten Krahnstoever DavisonDanielle Symons Downs
Jun 26, 2003·International Endodontic Journal·S LiapatasD Rontogianni

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