title: Reversal of midazolam sedation with flumazenil following conservative dentistry.
abstract: The purpose of this double-blind randomized study was to assess recovery of mental function following reversal of midazolam-induced sedation with the specific antagonist flumazenil (R015-1788) or placebo following conservative dental procedures. Recovery was assessed using choice reaction time and critical flicker fusion threshold, both objective tests of psychomotor function; linear analogue sedation scores and simple memory tests. Assessments were repeated up to 3 h after administration of flumazenil or placebo to discover whether recovery was sustained or whether resedation occurred due to the short duration of action of flumazenil. Flumazenil in doses from 0.5 to 1.0 mg rapidly reversed the sedative and amnesic effects of a mean dose of 8.2 mg of midazolam without apparent evidence of subsequent resedation. Since recovery of mental function in the control group had ordinarily occurred 45 min after administration of placebo, routine reversal of midazolam sedation with flumazenil cannot be justified. Nevertheless, in cases of undue sedation persisting after dental treatment, flumazenil may be used with minimal risk of resedation occurring.
authors.affiliation: Department of Anaesthesia, Ninewells Teaching Hospital, Dundee, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Davies
authors.forename: C M
authors.initials: CM
authors.lastname: Sealey
authors.forename: J I
authors.initials: JI
authors.lastname: Lawson
authors.forename: I S
authors.initials: IS
authors.lastname: Grant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000762:Anesthesia Recovery Period; D000766:Anesthesia, Dental; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D005442:Flumazenil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008874:Midazolam / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D008875:Middle Aged; D011184:Postoperative Period; D011597:Psychomotor Performance / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic
chemical_list: D005442:Flumazenil; D008874:Midazolam