Flumazenil, a specific benzodiazepine (BZ) antagonist, has been used in our department for treatment of some emergency cases. We treated different groups of comatose patients according to a standard protocol: patients with iatrogenic BZ overdosage, patients with intentional BZ intoxication, and alcoholic patients with head trauma. On the basis of our experience we can say that: (1) administration of a single 1 mg i.v. flumazenil bolus immediately brought about complete recovery of consciousness in pure BZ intoxications; (2) no adverse events (cardiocirculatory, respiratory, neurological, psychiatric) were observed in epileptics or in delirium tremens patients; (3) continuous infusion (0.5 mg h-1) was necessary for maintenance of the therapeutic effect. In conclusion flumazenil is an effective therapeutic agent in the primary management of BZ poisoning and a useful therapeutic and/or diagnostic tool in unclear comatose states; furthermore it could be used in particular situations such as alcoholic intoxication and hepatic coma, in which abnormal GABA-ergic transmission plays a role. Good tolerance of flumazenil makes it a safe agent, even in patients in coma not resulting from BZ overdosage.

Mapelli, A., Bellinzona, G., Lorini, F., Noli, S., Sicignano, A. (1988). Diagnostic and therapeutic use of flumazenil in emergency medicine. EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 5(suppl 2), 295-299.

Diagnostic and therapeutic use of flumazenil in emergency medicine

Lorini F;
1988

Abstract

Flumazenil, a specific benzodiazepine (BZ) antagonist, has been used in our department for treatment of some emergency cases. We treated different groups of comatose patients according to a standard protocol: patients with iatrogenic BZ overdosage, patients with intentional BZ intoxication, and alcoholic patients with head trauma. On the basis of our experience we can say that: (1) administration of a single 1 mg i.v. flumazenil bolus immediately brought about complete recovery of consciousness in pure BZ intoxications; (2) no adverse events (cardiocirculatory, respiratory, neurological, psychiatric) were observed in epileptics or in delirium tremens patients; (3) continuous infusion (0.5 mg h-1) was necessary for maintenance of the therapeutic effect. In conclusion flumazenil is an effective therapeutic agent in the primary management of BZ poisoning and a useful therapeutic and/or diagnostic tool in unclear comatose states; furthermore it could be used in particular situations such as alcoholic intoxication and hepatic coma, in which abnormal GABA-ergic transmission plays a role. Good tolerance of flumazenil makes it a safe agent, even in patients in coma not resulting from BZ overdosage.
Articolo in rivista - Articolo scientifico
flumazenil; emergency; medicine
English
295
299
5
Mapelli, A., Bellinzona, G., Lorini, F., Noli, S., Sicignano, A. (1988). Diagnostic and therapeutic use of flumazenil in emergency medicine. EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 5(suppl 2), 295-299.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/337435
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