title: Sedation for day-case urology: an assessment of patient recovery profiles after midazolam and flumazenil.
abstract: The specific antagonist flumazenil has been shown to reverse the central actions of benzodiazepines. Its use, in day-case procedures performed under benzodiazepine sedation, offers the potential for enhanced patient recovery. However, concern has been expressed over the possibility of resedation given the short elimination half-life of flumazenil. A randomised, double-blind, placebo controlled trial was therefore designed to assess patient recovery profiles after flumazenil. A total of 44 adults were entered into the trial. Recovery was assessed by means of a battery of psychomotor tests performed pre- and postoperatively. Psychomotor function in patients receiving flumazenil returned to, or near to, baseline levels within 15 min of administration--an improvement maintained throughout the 6 h test period. Patients receiving placebo did not recover fully until the 2 h test point--significant differences between the two groups existing at 15 min and 1 h. In this study, flumazenil effectively reversed midazolam-induced sedation without evidence of resedation. The implications for day-case surgery are discussed.
authors.affiliation: Department of Minimally Invasive Surgery, Royal Northern Hospital, London.
authors.forename: B R
authors.initials: BR
authors.lastname: Birch
authors.forename: K M
authors.initials: KM
authors.lastname: Anson
authors.forename: D V
authors.initials: DV
authors.lastname: Kalmanovitch
authors.forename: J
authors.initials: J
authors.lastname: Cooper
authors.forename: R A
authors.initials: RA
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D016292:Procedural Sedation; D003558:Cystoscopy; D004311:Double-Blind Method; D005260:Female; D005442:Flumazenil; D006801:Humans; D008297:Male; D008874:Midazolam / Q000037:antagonists & inhibitors*; D008875:Middle Aged; D011597:Psychomotor Performance / Q000187:drug effects; D014572:Urology
chemical_list: D005442:Flumazenil; D008874:Midazolam