Antagonism of benzodiazepine-fentanyl anaesthesia with flumazenil. 1990

S Kaukinen, and J Kataja, and L Kaukinen
Department of Anaesthesia, Tampere University Central Hospital, Finland.

The specific benzodiazepine antagonist flumazenil (Ro 15-1788) (Ro) was given in a double-blind study to 40 adult orthopaedic patients in order to determine if it shortens the immediate recovery time after benzodiazepine-fentanyl anaesthesia. On the evening before operation the patients were premedicated orally with 1-2 mg of flunitrazepam and 30 min before the induction of anaesthesia with 7.5 mg midazolam. Induction of anaesthesia was carried out with flunitrazepam 0.03-0.04 mg.kg-1 and fentanyl 0.1 mg IV. Anaesthesia was maintained with fentanyl (5.9 microgram.kg-1.h-1) and nitrous oxide. After the reversal of muscle relaxation, 20 patients received a placebo and 20 patients Ro, as boluses up to 10 ml, until the effect of awakening was noticed. The dose of Ro (0.1 mg.ml-1) required was 6.8 +/- 2.9 micrograms.kg-1 and that of placebo 10 +/- 0 ml. Patients given Ro woke up faster than patients given placebo. Ro patients were more alert than patients given placebo until 120 min after the injection or the test drug. After this patients in both groups behaved similarly. Eight patients given Ro and one given placebo showed some mild adverse reaction for 5-60 min after the administration of Ro or placebo (e.g., nausea, shivering). This study indicates that flumazenil speeds up awakening after benzodiazepine-fentanyl anaesthesia.

UI MeSH Term Description Entries
D008297 Male Males
D008874 Midazolam A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH. Dormicum,Midazolam Hydrochloride,Midazolam Maleate,Ro 21-3981,Versed,Hydrochloride, Midazolam,Maleate, Midazolam,Ro 21 3981,Ro 213981
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011229 Preanesthetic Medication Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic. Medication, Preanesthetic,Medications, Preanesthetic,Preanesthetic Medications
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260 Female Females
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D005442 Flumazenil A potent benzodiazepine receptor antagonist. Since it reverses the sedative and other actions of benzodiazepines, it has been suggested as an antidote to benzodiazepine overdoses. Flumazepil,Anexate,Lanexat,Ro 15-1788,Romazicon,Ro 15 1788,Ro 151788
D005445 Flunitrazepam A benzodiazepine with pharmacologic actions similar to those of DIAZEPAM that can cause ANTEROGRADE AMNESIA. Some reports indicate that it is used as a date rape drug and suggest that it may precipitate violent behavior. The United States Government has banned the importation of this drug. Fluridrazepam,Rohypnol,Fluni 1A Pharma,Flunibeta,Flunimerck,Fluninoc,Flunitrazepam-Neuraxpharm,Flunitrazepam-Ratiopharm,Flunitrazepam-Teva,Flunizep Von Ct,Narcozep,RO-5-4200,Rohipnol,Flunitrazepam Neuraxpharm,Flunitrazepam Ratiopharm,Flunitrazepam Teva,RO54200,Von Ct, Flunizep
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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