Whitwam J G
Department of Anaesthetics, Royal Postgraduate Medical School, London, UK.
Acta Anaesthesiol Scand Suppl. 1990;92:16-20; discussion 47. doi: 10.1111/j.1399-6576.1990.tb03175.x.
Benzodiazepines, used correctly, provide a relatively safe means of providing sedation in a variety of clinical situations and midazolam, which is shorter acting than other benzodiazepines (BZ), is the drug of choice in ambulatory patients. Flumazenil is a highly effective specific competitive BZ antagonist which provides a safe means of rapidly attenuating or terminating BZ sedation. Its mean half-life is 54 min, and in this contact the optimal dosage is 0.2 to 0.5 mg. Although it reverses sedation and amnesia, there is still a question about whether its efficacy in reversing the respiratory depressant effects of benzodiazepines is adequate. This remains an area of critical debate, as does resedation and also its administration to chronic benzodiazepine users. The use of flumazenil to reverse midazolam-induced sedation introduces, for the first time, the possibility of terminating sedation at a predetermined time. Were it to be adopted routinely, it has major implications for the improvement of patient management affecting all aspects of post-operative care.
正确使用苯二氮䓬类药物能在多种临床情况下提供相对安全的镇静方法，而咪达唑仑的作用时间比其他苯二氮䓬类药物短，是门诊患者的首选药物。氟马西尼是一种高效的特异性竞争性苯二氮䓬类拮抗剂，能提供一种安全的方法来迅速减轻或终止苯二氮䓬类药物引起的镇静作用。其平均半衰期为54分钟，在此情况下最佳剂量为0.2至0.5毫克。虽然它能逆转镇静和失忆，但它在逆转苯二氮䓬类药物的呼吸抑制作用方面的疗效是否足够仍存在疑问。这仍然是一个关键的争论领域，再镇静以及对长期使用苯二氮䓬类药物的患者使用该药也是如此。使用氟马西尼逆转咪达唑仑引起的镇静作用首次引入了在预定时间终止镇静的可能性。如果常规采用，它对改善患者管理具有重大意义，会影响术后护理的各个方面。
