Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
J Dig Dis. 2018 Feb;19(2):93-101. doi: 10.1111/1751-2980.12579.
Midazolam sedation during elective endoscopy is widely performed and flumazenil is frequently administered after endoscopy to reverse sedation in clinical practice. This study aimed to investigate the safety and efficacy of flumazenil injections after elective endoscopy under midazolam sedation.
Participants who underwent an upper endoscopy under midazolam sedation were randomly divided into two groups. In group I, flumazenil was administered i.v. 10 min after the patient's transfer to the recovery room, and no antidote was injected in group II. The time of stay in the recovery room and adverse events were reviewed through the nursing records. We asked the patients about their pain and degree of satisfaction according to a visual analogue scale (VAS), their memory of the procedure, mental status and the presence of uncomfortable symptoms on the day of the procedure and the day afterwards.
The length of stay in recovery was significantly shorter in group I than in group II. No significant differences were found in the number of patients with pain (VAS ≥1), adverse events and discomfort between the two groups. Additionally, there were no differences in the patients' memory of the procedure, satisfaction with sedation, willingness to repeat the endoscopy and mental status.
The time in the recovery room after flumazenil administration was significantly shortened, and the use of the drug did not increase the risk of adverse events or discomfort. The use of flumazenil for reversing midazolam sedation seems to be safe and effective.
在择期内镜检查中，咪达唑仑镇静广泛应用，氟马西尼常被用于临床实践中以逆转镇静作用。本研究旨在探讨咪达唑仑镇静下择期内镜检查后氟马西尼注射的安全性和有效性。
接受咪达唑仑镇静下上消化道内镜检查的参与者被随机分为两组。在组 I 中，患者转入恢复室 10 分钟后静脉注射氟马西尼，而在组 II 中不注射解毒剂。通过护理记录回顾恢复室停留时间和不良事件。我们根据视觉模拟评分（VAS）询问患者关于疼痛和满意度、对手术过程的记忆、手术当天和次日的精神状态和不适症状。
组 I 的恢复室停留时间明显短于组 II。两组患者的疼痛（VAS≥1）、不良事件和不适的发生率无显著差异。此外，两组患者对手术过程的记忆、镇静满意度、重复内镜检查的意愿和精神状态均无差异。
氟马西尼给药后恢复室停留时间明显缩短，且药物使用并未增加不良事件或不适的风险。氟马西尼逆转咪达唑仑镇静作用似乎是安全有效的。
