ABSTRACT
Fifty outpatients who underwent upper gastrointestinal endoscopy under midazolam sedation were allocated randomly into two equal groups of 25 in this double-blind study. After the endoscopy, and 30 minutes after administration of the sedative, patients in one group received flumazenil 0.5 mg; those in the other group received a similar volume of vehicle only. Assessments of memory function, psychomotor performance and coordination were carried out and these were repeated 3.5 hours later. Flumazenil produced a significant improvement (p less than 0.001) immediately but no difference could be detected between flumazenil and placebo at 3.5 hours. However, patients in the flumazenil group reported, by means of linear analogue scales, a subjective feeling of alertness at the time of discharge, which was greater than that reported by those in the placebo group (p less than 0.005).
Subject(s)
Ambulatory Care , Endoscopy , Flumazenil/pharmacology , Midazolam/antagonists & inhibitors , Adolescent , Adult , Aged , Double-Blind Method , Flicker Fusion/drug effects , Humans , Memory/drug effects , Midazolam/pharmacology , Middle Aged , Prospective Studies , Psychomotor Performance/drug effects , Randomized Controlled Trials as Topic , Reaction Time/drug effects , Time FactorsABSTRACT
Strain gauge venous occlusion plethysmography was used to measure arterial flow, venous capacity and maximum venous outflow in the calves of seven patients undergoing gynaecological surgery. Plethysmography was performed before surgery, before, and for 30 min after, the extradural injection of 0.5% bupivacaine. On the morning after surgery, 0.5% bupivacaine was injected extradurally and plethysmography performed. With regression of the extradural blockade and the re-emergence of pain, analgesia was produced with diamorphine i.v. and plethysmography repeated. Control measurements were also made. Compared with a mean control value of 100% (3.4 ml dl-1 min-1) calf arterial flow increased from 160% to 285% after the preoperative extradural blockade, and from 123% to 191% following the postoperative analgesic extradural blockade, but there was no significant change when pain was relieved after i.v. diamorphine. Mean arterial pressure changed insignificantly after all the injections. No significant changes were measured in venous capacity or maximum venous outflow.
