title: The role of midazolam and flumazenil in urology.
abstract: The effects of midazolam (3-10 mg i.m.) and their reversal by flumazenil were studied in transurethral endoscopic procedures performed using topical analgesia. In one randomised study, patients (n = 84) received either no medication or flumazenil (0.5 mg i.v.) on completion of endoscopy. Recovery was assessed subjectively. Within 15 min, 83% of those receiving flumazenil were considered ready for discharge compared with only 24% of the control group (P less than 0.001). In a second randomised, double-blind, placebo-controlled trial of 44 patients, post-operative recovery was assessed using five objective psychomotor tests. Whereas the placebo group took up to 2 h to recover, those receiving flumazenil recovered fully or returned to near control values within 15 min. Sedoanalgesia--a technique combining adequate local anaesthesia with sedation (using midazolam)--has wide application in urology, and the introduction of flumazenil has major implications for the practice of day-case surgery.
authors.affiliation: Institute of Urology, London, UK.
authors.forename: B R
authors.initials: BR
authors.lastname: Birch
authors.forename: K
authors.initials: K
authors.lastname: Anson
authors.forename: J
authors.initials: J
authors.lastname: Gelister
authors.forename: C
authors.initials: C
authors.lastname: Parker
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; D003558:Cystoscopy; D004311:Double-Blind Method; D005260:Female; D005442:Flumazenil / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D008874:Midazolam / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D008875:Middle Aged; D010147:Pain Measurement; D010865:Pilot Projects; D011597:Psychomotor Performance / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic
chemical_list: D005442:Flumazenil; D008874:Midazolam