A randomised, controlled trial of cognitive and psychomotor recovery from midazolam sedation following reversal with oral flumazenil

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Title: A randomised, controlled trial of cognitive and psychomotor recovery from midazolam sedation following reversal with oral flumazenil
Author(s): Girdler, Nicholas Martin; Lyne, J. P.; Wallace, R.; Neave, Nick J.; Scholey, A.; Wesnes, Keith A.; Herman, C.
Abstract: SummaryFlumazenil is traditionally administered intravenously to reverse the adverse effects of over sedation with benzodiazepines. The aim of this study was to test postoperative cognitive and psychomotor recovery from midazolam conscious sedation, following reversal with orally administered flumazenil. It was hypothesised that when administered by the oral route, flumazenil may enhance recovery over a prolonged period, thus increasing safety. Eighteen patients requiring intravenous midazolam sedation for dental treatment completed a randomised, double-blind, crossover trial. Following treatment the patients' sedation was reversed using either flumazenil or saline (asplacebo), administered orally, on alternate appointments. Assessment of mood and cognitive function were undertaken using ClinPhone.cdr®, a highly sensitive and specific computerised battery of cognitive tests administered by telephone prior to sedation and every hour for seven hours post reversal. Results indicate that within 20 min of administration, oral flumazenil is capable of partially reversing some cognitive and psychomotor impairments but the attentional and stimulus discrimination effects of midazolam sedation still remain.
Publication type: Journal article
Source: Anaesthesia, Vol. 57, no. 9 (Sep 2002), pp. 868-876
Publication year: 2002
Keyword(s): Alertness; Anesthetic recovery; Antagonists; Antidotes; Anxiety; Attention; Benzodiazepine receptor blocking agent; Benzodiazepines; Cognition; Cognitive defect; Conscious sedation; Dental anesthesia; Dental anxiety; Dental care; Drug antagonism; Drug metabolism; Drug safety; Flumazenil; Hypnotic sedative agent; Hypnotics; Memory; Mental test; Midazolam; Mood; Oral administration; Postoperative care; Psychologic test; Psychometrics; Psychomotor disorder; Psychomotor performance; Reaction time; Response time; Sedation; Sedatives; Short-term memory; Sodium chloride; Telephone; Word recognition; Working memory
Publisher: Wiley-Blackwell Publishing
ISSN: 0003-2409
Publisher URL: http://dx.doi.org/10.1046/j.1365-2044.2002.02785.x
Peer reviewed