[Effectiveness of the benzodiazepine antagonist Ro 15-1788 following anesthesia induced by flunitrazepam].

The competitive benzodiazepine antagonist Ro 15-1788 proved efficacious after general anaesthesia induced by flunitrazepam. It showed a quick onset of action within 1-2 min. After antagonisation, the heart rate, blood pressure and respiratory rate remained stable. No increased demand for analgesics could be demonstrated postoperatively. A transient anxiety that could be observed in 7 of 38 patients after doses between 0.5 and 2.0 mg seemed of minor clinical importance but may indicate that Ro 15-1788 acted not only as a pure antagonist but as a partially inverse agonist as well. Recurrence of sedation could be observed in 6 out of 38 patients after 2 h of Ro 15-1788 dosage. Careful observation of the patients for at least 2 h is therefore recommended even if antagonisation seemed successful. It was possible to reverse the benzodiazepine action successfully with doses between 0.3 and 0.8 mg. After these doses the patients will awake gently and gradually and unwanted side effects will be avoided. In our experience, Ro 15-1788 is a useful improvement in benzodiazepine application after surgical anaesthesia.