title: Safety of rapid administration of flumazenil in patients with ischaemic heart disease.
abstract: The purpose of this study was to determine if higher (36 micrograms.kg-1) doses of flumazenil (a new benzodiazepine (BZ) antagonist) produced an effect on haemodynamics. Twelve patients with class III-IV angina were entered into this double-blind randomised placebo-controlled study. BZ were withheld for 2 weeks prior to surgery. Patients were placed on an ambulatory monitor 18 h prior to surgery to record changes in heart rate rhythm and ST segment changes. The patients were given secobarbital 100-200 mg and morphine 0.12 mg.kg-1 90 min prior to surgery. Flumazenil or placebo was given in divided doses every 3 min (1 mg, 1 mg, 1 mg). Complete haemodynamic profiles were obtained at baseline and 2 min following each injection of flumazenil. Flumazenil produced a minimal but statistically significant reduction in systolic blood pressure (147 +/- 13.9 to 137 +/- 18.4 mmHg) and diastolic blood pressure (74 +/- 14.8 to 67 +/- 13 mmHg). There was no consistent effect on heart rate, pulmonary capillary wedge pressure or cardiac index. We conclude that flumazenil is safe when administered in relatively high doses to patients with ischaemic heart disease who have not received benzodiazepines.
authors.affiliation: Duke Heart Center, Durham, North Carolina.
authors.forename: N D
authors.initials: ND
authors.lastname: Croughwell
authors.forename: J G
authors.initials: JG
authors.lastname: Reves
authors.forename: C J
authors.initials: CJ
authors.lastname: Will
authors.forename: B J
authors.initials: BJ
authors.lastname: Kasson
authors.forename: D K
authors.initials: DK
authors.lastname: Goodman
mesh_terms: D003327:Coronary Disease / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D005442:Flumazenil / Q000008:administration & dosage / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D005442:Flumazenil