Diagnostic and therapeutic utility of flumazenil in comatose patients with drug overdose.
From July 1, 1990 and June 30, 1991, 61 unconscious patients with drug intoxication were prospectively enrolled into this study in order to evaluate the efficacy and safety of flumazenil in the management of this patient population. Flumazenil was injected intravenously as a 0.3-mg bolus in the first minute followed by 0.2-mg and 0.3-mg doses every minute until a total dose of 1 mg was given or until the patient responded. The Glasgow coma scale and a sedation-level scoring system were checked prior to and at 1, 5, and 30 minutes after the dose eliciting response or on completion of the full dose of flumazenil. The patients were divided into two groups based on their response to flumazenil: group 1, responders (N = 55), and group 2, nonresponders (N = 6). Eleven patients from group 1 allowed us to retrieve drug information from these patients once mental status had recovered and patients were treated accordingly. In two cases endotracheal intubation and artificial ventilation were rendered unnecessary by the use of flumazenil. No undesirable hemodynamic effects were noted after flumazenil injection in this study, although none of the patients overdosed on antidepressants. Flumazenil may serve as a useful diagnostic and therapeutic tool in the management of selected cases of drug-induced coma.
Chern
T L
TL
Emergency Department, Veterans General Hospital, Taipei, Taiwan.
Hu
S C
SC
Lee
C H
CH
Deng
J F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001569:Benzodiazepines / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D062787:Drug Overdose; D004630:Emergencies; D005260:Female; D005442:Flumazenil / Q000008:administration & dosage / Q000627:therapeutic use*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D001569:Benzodiazepines; D005442:Flumazenil