Reversal of sedation with flumazenil in regional anaesthesia: a review.
Five authors have described safe and effective sedation-reversal with flumazenil in 150 patients where a benzodiazepine (BZ) was used to supplement regional anaesthesia. Problems of post-reversal anxiety seen with high-dose bolus flumazenil (0.1 mg kg-1) were not seen when flumazenil was titrated to effect and 1.0 mg not exceeded. Efficacy was also demonstrated in reversing amnesia, disorientation and other measures of cognitive function. Resedation that occurred was not clinically important, but prevention of resedation should be by repeated small flumazenil doses, or infusion, rather than a very large initial dose. The use of flumazenil is indicated where BZ sedation during regional anaesthesia has become excessive or suddenly unnecessary, for example BZ paradoxical excitement, and where prompt return to full consciousness is required in day-stay surgery. Further research is required to compare the quality of BZ sedation and reversal with sedation and recovery from propofol.
D000368:Aged; D000765:Anesthesia, Conduction; D001007:Anxiety / Q000187:drug effects; D005260:Female; D005442:Flumazenil / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans
D005442:Flumazenil