Reversal of central benzodiazepine effects by intravenous flumazenil.

The purpose of this study was to determine the efficacy of flumazenil in safely expediting patient recovery from benzodiazepine sedation. This double-blind, randomized, placebo-controlled study involved 30 patients who received conscious sedation induced by intravenous midazolam given for a dental surgical procedure. Patients who received flumazenil were rated significantly more alert than were placebo-treated patients at 5 and 15 min following test drug administration. They also had significantly superior scores on the digital symbol substitution test and on tests in a comprehensive modified neurological examination 5 min after receiving flumazenil. Group differences were not as impressive on recall and recognition tests. However, flumazenil patients scored somewhat more favorably than the placebo group patients in identifying simple objects they had been shown during the observation period following surgery. Flumazenil appears to be a promising drug for reversing midazolam conscious sedation.