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Flumazenil reversal of psychomotor impairment due to midazolam or diazepam for conscious sedation for upper endoscopy.

Abstract：

BACKGROUND:Flumazenil is a competitive benzodiazepine antagonist that acts to reverse their sedative and hypnotic effects. It is indicated in the management of benzodiazepine overdose, but its role in the routine reversal of endoscopic conscious sedation has not been defined. METHODS:Patients undergoing diagnostic upper endoscopy who received sedation with either diazepam or midazolam alone were given flumazenil 0.2 mg incrementally immediately following the procedure until awake. They were then asked to repeat three psychomotor tests measuring cognitive and motor skills, with their baseline scores compared with postprocedure scores over a 3-hour period. RESULTS:Full psychomotor function was restored to baseline values within 30 minutes after flumazenil in 79% of patients, with no differences in the reversal of psychomotor skill impairment observed between diazepam and midazolam sedation. There was no evidence of rebound sedation seen for up to 3 hours. No significant anterograde amnesia was evident in 78% of individuals. CONCLUSIONS:These results demonstrate that flumazenil's effects on reversing psychomotor impairment are similar when midazolam or diazepam are used for conscious sedation. However, the potential usefulness of routine flumazenil reversal of conscious sedation will require further evaluation of specific psychomotor performance skills (such as driving a car) before we lift the admonition against leaving the endoscopic suite unattended, driving a vehicle, or operating complicated machinery for several hours.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Kankaria A,Lewis JH,Ginsberg G,Gallagher J,al-Kawas FH,Nguyen CC,Fleischer DE,Benjamin SB

doi

10.1016/s0016-5107(96)70091-3

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

416-21

issue

4

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(96)70091-3

journal_volume

44

pub_type

临床试验,杂志文章,随机对照试验

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