Breheny F X
Intensive Care Unit, Fremantle Hospital, Australia.
Crit Care Med. 1992 Jun;20(6):736-9. doi: 10.1097/00003246-199206000-00006.
To demonstrate the efficacy of flumazenil in reversing the sedative action of midazolam in ventilated intensive care patients.
Prospective, double-blind randomized study.
ICU of a tertiary, university-affiliated teaching hospital.
Thirty ICU patients requiring artificial ventilation for greater than 12 hrs were studied.
All patients received a midazolam infusion for sedation. Twenty-nine patients received supplementary narcotics. At the end of the sedation period, either flumazenil or placebo was administered to all the patients in a double-blind, randomized fashion, and the effects were observed.
Sedation levels were measured hourly during the infusion; at the end of the infusion; and at 5, 15, 30, 60, and 120 mins after cessation of the midazolam infusion. Midazolam concentrations in serum were measured at the time of cessation of the midazolam infusion and at 30, 60, and 120 mins later. Reversal of sedation was observed in 14 of 15 patients who received flumazenil, and resedation occurred in seven of these patients. Reversal was not seen in any of the patients who received placebo. Midazolam serum concentrations were similar in both groups.
Flumazenil in a dose of 0.15 mg is a safe drug that reverses the sedative effect of midazolam.
证明氟马西尼可逆转咪达唑仑在机械通气重症监护患者中的镇静作用。
前瞻性、双盲随机研究。
一所大学附属三级教学医院的重症监护病房。
研究了30例需要机械通气超过12小时的重症监护病房患者。
所有患者均接受咪达唑仑输注以进行镇静。29例患者接受了辅助性麻醉药。在镇静期结束时，以双盲、随机方式给所有患者使用氟马西尼或安慰剂，并观察效果。
在输注期间每小时测量镇静水平；输注结束时；以及在咪达唑仑输注停止后5、15、30、60和120分钟测量。在咪达唑仑输注停止时以及30、60和120分钟后测量血清中咪达唑仑的浓度。在接受氟马西尼的15例患者中，有14例观察到镇静作用逆转，其中7例患者再次出现镇静。接受安慰剂的患者均未出现逆转。两组患者的咪达唑仑血清浓度相似。
剂量为0.15 mg的氟马西尼是一种可逆转咪达唑仑镇静作用的安全药物。
