The Effects of Flumazenil after Midazolam Sedation during Spinal Anesthesia / 대한마취과학회지

The effects of flumazenil, a benzodiazepine antagonist were evaluated in a clinical study in which midazolam (0.1 mg/kg) was used as a sedative agent during the spinal anesthesia. Sixty patient were divided into two groups as group F (n=30) and group S (n=30). Flumazenil 0.3 mg (3 mL) in group F and saline 3 mL in group S were administered at the end of surgery. Blood pressure, pulse rate, respiratory rate and oxygen saturation (SaO2) were checked just before and at, 5, 15, 30, 60 and 120 minutes after the administration of flumazenil or saline. Also we evaluated the level of conciousness and orientation in time and space. The results were as follows; 1) Changes in blood pressure, pulse rate and respiratory rate were not different between two groups, exeept SaO2 was which increased significantly in the flumazenil group. 2) The flumazenil group revealed improved level of consciousness and orientation in time and space which began 5 minutes after flumazenil and was maintained 30 minutes thereafter. 3) We could not observe the any side effects of flumazenil.

Effects of Midazolam on CNS and Antagonistic Effect of Flumazenil / 대한마취과학회지

The effects of midazolam and diazepam which were used as an induction agent of general anesthesia were evaluated. And flumazenil which is a potent competitive inhibitor of the specific binding of benzodiazepines at the receptor level was evaluated too. Sixty patients were divided into three groups as follows: Group I (n=20); Midazolam (average 0.24 mgkg-1) was administered as an induction agent and flumazenil (average 0.24 mgkg-1) was administered in recovery room Group II (n=20); Diazepam (average 0.35 mgkg-1) was administered as an induction agent and flumaxenil (average 0.25 mgkg-1) was administered in recovery room Group III (n=20); Midazolam (average 0.24 mgkg-1) was administered as an induction agent and normal saline was administered in recovery room instead of flumaxenil The result were as follows: 1) Systolic and diastolic blood pressure and heart rate were not changed significantly, except diastolic blood pressure decreased significantly (p<0.05) in group II, after intravenous administration of midazolam and diazepam. But these were all increased significantly (p<0.001) after endotracheal intubation in all groups. 2) Systolic and diastolic blood preasure and heart rate were not changed significantly after intravenous administration of flumazenil in group I, II and there were no significant differences between each groups. 3) Tidal volume was increased significantly (p<0.05) in group 1 from 15 min after administration of flumazenil. There were no significant changes in all groups in respiratory rate. SaO2 was increased significantly (p<0.05, p<0.001) in group I, II from 5 min after administration of flumazenil. But it was increased significantly (p<0.05) in group III from 20 min after administration of normal saline too. EtCO2 was decreased insignificantly in all groups. 4) Recovery from anesthesia according to Modified Steward Coma Scale was much improved immediately after administration of flumazenil and was significant (p<0.001) statistically in group I, II from 5 min after administration of flumazenil and reached complete recovery from 20 min after administration of flumaxenil. It was increased gradually and become significant in group III from 10 min after administration of normal saline. These changes of group I, II were significant (p<0.05) compared with group III and reached complete recovery from 60 min after administration of flumazenil.

The Effects of Flumanzenil ( Ro 15-1788 ) at the Conclusion of Anesthesia in the Patients Who Received Midazolam ( Ro 21-3981 ) as an Induction Agent / 대한마취과학회지

The actions and side effcts of the benzodiazepine antagonist flumazenil were evaluated in a clinical study in which midazolam was used as an anesthetir induction agent. Anesthesia was maintained with nitrous oxide-oxygen-fentanyl. Sixty-five adult surgical patients received either 0.3 mg (3 ml) of flumazenil (33 cases) or 3 ml of saline (32 cases) at the conclusion of surgery. Blood pressure, pulse rate, and respiratory rate were checked before premedication, just before, 5 minutes, 30 minutes, and 120 minutes after the administration flumazenil or saline. Also level of consciouseness, orientation in time and space, and cooperativeness along with end tidal carbon dioxide and hemoglobin oxygen saturation were evaluated. Various larboratory parameters were checked before premedication and 24 hours after operation. The results were as follows: 1) The flumazenil group revealed improved level of consciousness, orientation in time and space, and cooperativeness which began just after the administration, and was maintained 30 minutes thereafter. 2) There was no difference in the changes of laboratory parameters between the two groups. 3) The changes of blood pressure, pulse rate, respiratory rate, and SaO2 showed no difference between those two groups. 4) The end tidal concentrations of carbon dioxide after drug administration were significantly lower in the flumazenil group than those of the saline group. 5) Tolerance to flumazenil (0.3 mg) was good without any side effect.