Role of flumazenil in reversing the sedative effect of benzodiazepines in endoscopies : Salmaniya Medical Centre experience

Abstract EN

Thirty seven patients undergoing endoscopic procedures were sedated with either midazolam 0.15mg -0.2mg/kg or diazepam 0.2 - 0.3 mg/kg intravenously.

The sedative effect was reversed in 27 patients with flumazenil (Anexate) 0.2mg initially and then in incremental doses of O.lmg.

The remaining ten patients served as control group by allowing them to recover spontaneously.

The efficacy of flumazenil was evaluated by the degree of sedation, comprehension and co-operation, orientation to space and time and re-sedation.

The safety of flumazenil was evaluated by local and systemic tolerability.

We conclude that flumazenil is a safe and effective benzodiazepine antagonist, and that the recovery of patients given this antagonist is both quick and complete.

Benzodiazepines are the most commonly used seda-tive-hypnotics1.

While we already have reliable antagonist for the opiate analgesics and the non-depolarising muscle relaxant drugs, which have become essential to modem anaesthesiology, no such antagonist has so far been available to reverse the effects of benzodiazepines.

There was no alternative but to wait until these effects subside spontaneously2.

The specific antagonist has become an absolute necessity especially in total intravenous anaesthesia and in balanced anaesthesia.

The discovery of flumazenil has enabled us to sedate the patients completely as we can reverse this effect post-operatively to get a well oriented patients3.

The aim of this study is to evaluate the efficacy and safety of flumazenil in patients sedated with benzodiazepines for endoscopic procedures, at Salmaniya Medical Centre (SMC).