title: Effect of flumazenil on disturbance of equilibrium function induced by midazolam.
abstract: Benzodiazepines in intravenous sedation are useful, owing to their outstanding amnesic effect when used for oral surgery as well as dental treatments on patients with intellectual disability or dental phobia. However, compared with propofol, the effect of benzodiazepine lasts longer and may impede discharge, especially when it is administered orally because of fear of injections. Although flumazenil antagonizes the effects of benzodiazepine quickly, its effect on the equilibrium function (EF) has never been tested. Since EF is more objective than other tests, the purpose of this study is to assess the sedation level and EF using a computerized static posturographic platform. The collection of control values was followed by the injection of 0.075 mg/kg of midazolam. Thirty minutes later, 0.5 mg or 1.0 mg of flumazenil was administered, and the sedation level and EF were measured until 150 minutes after flumazenil administration. Flumazenil antagonized sedation, and there was no apparent resedation; however, it failed to antagonize the disturbance in EF. This finding may be due to differences in the difficulty of assessing the sedation level and performing the EF test, and a greater amount of flumazenil may effectively antagonize the disturbance in EF.
authors.affiliation: Department of Dental Anesthesiology, Okayama University Dental Hospital, Japan. maedas@md.okayama-u.ac.jp
authors.forename: S
authors.initials: S
authors.lastname: Maeda
authors.forename: T
authors.initials: T
authors.lastname: Miyawaki
authors.forename: H
authors.initials: H
authors.lastname: Higuchi
authors.forename: M
authors.initials: M
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D016292:Procedural Sedation / Q000379:methods*; D055191:Delayed Emergence from Anesthesia; D003936:Diagnosis, Computer-Assisted; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005442:Flumazenil / Q000008:administration & dosage*; D018757:GABA Modulators / Q000008:administration & dosage*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D007275:Injections, Intravenous; D008874:Midazolam / Q000037:antagonists & inhibitors / Q000494:pharmacology*; D004856:Postural Balance / Q000187:drug effects*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D018757:GABA Modulators; D006993:Hypnotics and Sedatives; D005442:Flumazenil; D008874:Midazolam
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