Flumazenil is indicated for reversal of sedation from benzodiazepines administered during therapeutic or diagnostic procedures and during induction or maintenance of general anesthesia, as well as for benzodiazepine overdose. Bolus doses of flumazenil are usually adequate to achieve reversal; however, when medical conditions may lead to a prolonged half-life of the benzodiazepine involved, continuous infusion may be warranted. A 67-year-old man with chlordiazepoxide toxicity required a 9-day infusion of flumazenil to prevent resedation and respiratory insufficiency; he initially was admitted to the hospital for alcohol detoxification. Concomitant medical conditions and the metabolism characteristics of each benzodiazepine must dictate the agent of choice. When measures are required to ensure adequate recovery of a patient's respiratory function and mental awareness, such as in patients with benzodiazepine toxicity, consideration of continuous-infusion flumazenil is warranted.
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http://dx.doi.org/10.1592/phco.23.14.1513.31941 | DOI Listing |
J Neurosurg Anesthesiol
July 2024
Department of Anesthesiology, Niigata University Medical and Dental Hospital, Niigata.
Drug Des Devel Ther
May 2024
Department of Anesthesiology, Lianyungang Clinical College of Nanjing Medical University, Lianyungang, Jiangsu, People's Republic of China.
Purpose: Remimazolam tosilate is a novel ultrafast-acting benzodiazepine that has a rapid emergence even after continuous infusion when using flumazenil. So far, relatively few articles are still focusing on the quality of recovery after general anesthesia with remimazolam, especially in day surgery. This study aimed to compare the early postoperative quality of recovery of remimazolam tosilate with flumazenil and propofol in patients undergoing day surgery.
View Article and Find Full Text PDFJ Clin Anesth
November 2023
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyukwan University School of Medicine, Seoul, Republic of Korea. Electronic address:
Study Objective: The emergence profiles in patients undergoing total intravenous anesthesia with either propofol or remimazolam with flumazenil reversal were compared.
Design: A prospective, double-blind, randomized trial.
Setting: An operating room and a post-anesthesia care unit (PACU).
Front Psychiatry
March 2021
Department of Internal Medicine, Addiction Unit, Verona University Hospital, Verona, Italy.
An effective approach in the treatment of benzodiazepine (BZD) overdosing and detoxification is flumazenil (FLU). Studies in chronic users who discontinued BZD in a clinical setting suggested that multiple slow bolus infusions of FLU reduce BZD withdrawal symptoms. The aim of this study was to confirm FLU efficacy for reducing BZD withdrawal syndrome by means of continuous elastomeric infusion, correlated to drugs plasma level and patients' compliance.
View Article and Find Full Text PDFJA Clin Rep
January 2021
Department of Anesthesia, Ube Industries Central Hospital, 750 Nishikiwa Ube, Yamaguchi, 755-0151, Japan.
Background: Patients with myotonic dystrophy may have increased sensitivity to drugs used for anesthesia. We successfully managed general anesthesia in a patient with myotonic dystrophy using a novel intravenous anesthetic, remimazolam.
Case Presentation: The patient was a 46-year-old man, 169 cm in height, and weighing 60 kg.
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