Utilisation du flumazénil (Ro 15-1788) après perfusion prolongée de midazolam en anesthésie pour chirurgie intracrânienne [Use of flumazenil (RO 15-1788) after prolonged infusion of midazolam in anesthesia for intracranial surgery]

Details

Serval ID
serval:BIB_1D7497A3B28D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Utilisation du flumazénil (Ro 15-1788) après perfusion prolongée de midazolam en anesthésie pour chirurgie intracrânienne [Use of flumazenil (RO 15-1788) after prolonged infusion of midazolam in anesthesia for intracranial surgery]
Journal
Annales Françaises d'Anesthésie et de Réanimation
Author(s)
Chiolero R.L., Ravussin P.A., Freeman J.
ISSN
0750-7658
Publication state
Published
Issued date
1988
Peer-reviewed
Oui
Volume
7
Number
1
Pages
17-21
Language
french
Abstract
Midazolam, with a half-life of about 1.5-3.5 h, is inappropriate for the maintenance of anaesthesia during long procedures, especially when rapid recovery is necessary. The efficacy of flumazenil, a specific benzodiazepine antagonist, in the treatment of patients with benzodiazepine overdose suggests that rapid recovery from anaesthesia induced and maintained with midazolam might be obtained in patients needing immediate assessment. The rate of recovery, the side-effects and the feasibility of an early and accurate neurological assessment were studied in 18 ASA III patients after craniotomy in whom the prolonged effects of midazolam had been antagonized by flumazenil. Surgery lasted 5.5 +/- 1.3 h (means +/- SD). The induction dose of midazolam was 0.32 +/- 0.08 mg.kg-1 and the infusion rate was 0.2 +/- 0.08 mg.kg-1.h-1. Fentanyl was added at a dose and rate of 5.0 +/- 3.6 micrograms.kg-1 and 2.0 +/- 0.9 micrograms.kg-1.h-1 respectively. At the end of the dressing, 0.5 mg of flumazenil (t0) was injected, followed by 0.1 mg every minute up to a total of 1 mg. After 2 min, 14 patients (78%) opened their eyes (p less than 0.05) and 13 (72%) obeyed orders (p less than 0.05). After 10 min, 16 patients (89%) were extubated and speaking. During the first 10 min, the Glasgow score and the sedation score used for this study showed the same progression, with 13 patients (72%) having a Glasgow score of 14-15 (p less than 0.05). Thereafter, both scores decreased progressively till t60, then increased again, reaching their t10 level at t120. Three patients required another dose of antagonist.(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords
Adult, Aged, Anesthesia Recovery Period, Anesthesia, Intravenous/methods, Brain Diseases/surgery, Female, Flumazenil/pharmacology, Humans, Male, Midazolam/antagonists & inhibitors, Middle Aged, Postoperative Period, Time Factors
Pubmed
Create date
24/01/2008 16:52
Last modification date
20/08/2019 12:53
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