A major disadvantage of intravenous anesthesia is the risk of prolonged recovery with sedation and respiratory depression. The relatively short-acting benzodiazepine, midazolam is widely used for intravenous anesthesia, but a prolonged recovery
period
is common when more than small dose are given. Flumazenil is a specific benzodiazepine antagonist acting on central nervous system receptor. To evaluate the recovery characteristics after balanced anesthesia using midazolam, meperidine and
nitrous
oxide
when reversing with flumazenil, twenty women who underwent cesarian section were divided into 2 groups: control group and flumazenil group, after the surgical procedure. Flumanzenil reversed the sedative effect of midazolam within few minutes.
The
patients were alert, cooperative, oriented and had good recall of events after awakening. These effects were statistically better with flumazenil than with placebo for up to 60 min after administration. SaO2 was significantly low in the
flumazenil
group
at 10, 20 and 40 minute. FTCO2 and respiratory rate were not significantly different between the two groups. ETCO2 gradually decreased during 60 minute in the control group, and respiratory rate gradually decreased in the flumazenil group, both
reaching
significant levels compared to the control values. SBP was significantly nigh at 5 minute compared with the control value in the flumazenil group, but there was no significant change in dBP. Pulse rate decreased during 60 minutes in both group.
There
was no significnat side effect. The availablility of flumazenil allows effective reversal of midazolam when this is used during general anesthesia.
|