Claeys M A, Camu F, Schneider I, Gepts E
Department of Anaesthesia, Flemish University of Brussels Medical Centre, Belgium.
Eur J Anaesthesiol Suppl. 1988;2:209-17.
The duration of action, dose requirements and efficacy of flumazenil, a specific benzodiazepine antagonist, were evaluated in 50 patients scheduled for orthopaedic surgery under local anaesthesia and flunitrazepam sedation. Fifteen minutes after injection of flunitrazepam 0.03 mg kg-1 the patients received placebo or flumazenil i.v. in a randomized, double-blind and titrated fashion. At selected time intervals, sedation, anterograde amnesia, muscular hypotonia, orientation in time and space, comprehension and collaboration were evaluated. Compared with placebo, flumazenil promptly reversed sedation for 30 min, hypotonia for 45 min and anterograde amnesia for 60 min, and improved orientation and collaboration for 60 min. However, after 90 min significant recurrent sedation was observed, while anterograde amnesia reappeared after 60 and up to 120 min. No side-effects were noted at any time. The dose of flumazenil required for reversal of flunitrazepam sedation was 0.35 +/- 0.15 mg (mean +/- SD).
在50例计划于局部麻醉和氟硝西泮镇静下接受骨科手术的患者中，评估了特异性苯二氮䓬拮抗剂氟马西尼的作用持续时间、剂量需求和疗效。注射0.03 mg/kg氟硝西泮15分钟后，患者以随机、双盲和滴定方式接受安慰剂或静脉注射氟马西尼。在选定的时间间隔，评估镇静、顺行性遗忘、肌张力减退、时间和空间定向、理解能力及配合程度。与安慰剂相比，氟马西尼能迅速逆转30分钟的镇静、45分钟的肌张力减退和60分钟的顺行性遗忘，并改善60分钟的定向和配合。然而，90分钟后观察到明显的再次镇静，而顺行性遗忘在60分钟至120分钟后再次出现。在任何时候均未观察到副作用。逆转氟硝西泮镇静所需的氟马西尼剂量为0.35±0.15 mg（均值±标准差）。
