The actions and side effects of the benzodiazepine antagonist Ro 15-1788 were evaluated in a randomized double-blind clinical study in which midazolam was used as an anaesthetic agent. Sixty women who underwent laparoscopy were treated with Ro 15-1788 or with placebo after the surgical procedure. Ro 15-1788 reversed the hypnotic effect of midazolam within a few minutes. The patients were alert, co-operative, oriented and had good recall of events after awakening. The effects were statistically better than placebo for up to 30 min after administration. Arterial pressure and heart rate remained stable and there were no significant side effects. The availability of Ro 15-1788 allows effective reversal of midazolam when this is used during general anaesthesia.
Spinal anaesthesia for herniotomies in former preterm infants at risk from postoperative apnoea was investigated in a prospective, uncontrolled study involving 164 infants. Hyperbaric tetracaine (0.5 rng-kg-l) with adrenaline was used. In 152 patients (92.7%) spinal blockade was achieved, in 12 (7.3%) general anaesthesia was given after unsuccessful lumbar puncture. Fifteen patients required supplementation of spinal anaesthesia. Intraoperative complications included 2 apnoea during lumbar puncture and 5 total spinal blocks. By the end of surgery all complications had been resolved. No patient with spinal anaesthesia developed prolonged apnoea after surgery. Spinal anaesthesia in former preterm infants seems to avoid prolonged postoperative apnoea. Disadvantages of the technique were failures due to technical difficulties and excessive spread of spinal blockade.
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