The use of flumazenil for benzodiazepine associated respiratory depression in postanesthesia recovery: risks and outcomes

Seelhammer, Troy G.; DeGraff, Eric M.; Behrens, Travis J.; Robinson, Justin C.; Selleck, Kristen L.; Schroeder, Darrell R.; Šprung, Juraj; Weingarten, Toby N.

doi:10.1016/j.bjane.2017.12.008

Cited by 5 publications

(3 citation statements)

References 19 publications

(23 reference statements)

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“…This furthers previous work in Mbnl2 KO mice where EEG recordings were conducted and found increased REM episodes ( Charizanis et al, 2012 ). We were primarily interested in how flumazenil may effect Mbnl2 KO mice activity because anesthesia and sleep share overlapping mechanisms ( Allada, 2008 ) and flumazenil acts as an antagonist to anesthesia and benzodiazepines ( Seelhammer et al, 2018 ; Benini et al, 2021 ) via binding to ɑ1/γ2 interface ( Sharbaf Shoar, 2022 ). In the present study, flumazenil treatment resulted in opposing responses in WT and Mbnl2 KO mice.…”

Section: Discussionmentioning

confidence: 99%

Altered Behavioral Responses Show GABA Sensitivity in Muscleblind-Like 2-Deficient Mice: Implications for CNS Symptoms in Myotonic Dystrophy

Edokpolor

Banerjee

McEachin

et al. 2022

eNeuro

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Section: Discussionmentioning

confidence: 99%

Altered Behavioral Responses Show GABA Sensitivity in Muscleblind-Like 2-Deficient Mice: Implications for CNS Symptoms in Myotonic Dystrophy

Edokpolor

Banerjee

McEachin

et al. 2022

eNeuro

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“…Flumazenil is a competitive benzodiazepine receptor antagonist that is used to reverse or block the effects of benzodiazepines [21,22]. Worthington et al reported that sedation of remimazolam was rapidly reversible by flumazenil (1.0 min flumazenil vs. 10.5 min placebo) [23].…”

Section: Discussionmentioning

confidence: 99%

Remimazolam tosilate in patients undergoing upper gastrointestinal endoscopy: a multicenter, randomized, dose-exploration, positive-controlled, parallel-group, phase II trial

et al. 2020

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IntroductionTo assess both the safety and efficacy of different doses of remimazolam tosilate (HR7056) in maintaining suitable sedation during upper gastrointestinal endoscopy and the reversibility of HR7056’s sedative effects with flumazenil.Material and methodsA total of 156 patients were enrolled and randomly received propofol (group A), 1 of 3 induction doses of HR7056 (8.0 mg (group B), 7.0 mg (group C), 5.0 mg (group D)), or 5.0 mg of HR7056 plus flumazenil (group E). The primary efficacy endpoint was the successful sedation rate. Adverse events (AEs) were recorded to evaluate safety.ResultsBaseline characteristics of patients were well balanced between five treatment groups. For the dose-exploration part, there were no significant difference in successful sedation rate, rates of hypotension and respiratory depression between the four treatment groups. The sedative recovery time in group A was significantly higher than that in group B. The rate of hypoxemia and pain on injection in group A were both significantly higher than those in groups B, C and D. For the flumazenil reversal part, there was no significant difference in the sedative recovery time between group D and group E. The rates of AEs in groups A, B, C, D, E were 40.00%, 29.03%, 16.13%, 6.45%, 6.67%, respectively. There were no serious AEs.ConclusionsHR7056 was comparable to propofol in safety and efficacy in maintaining sedation during upper gastrointestinal endoscopy. HR7056 5.0/2.5 mg-dose (initial dose 5.0 mg, combined with supplemental doses of 2.5 mg) was capable of inducing rapid sedation without the need for flumazenil reversal.

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“…The physiological disadvantages of prolonged anesthesia have been widely discussed and include, among others, arrhythmias, myocardial depression, hypotension, hypoxia, and pulmonary complications [22,23]. An association has been reported between a higher incidence of pulmonary complications in the postoperative period of abdominal surgery and the average duration of surgery exceeding 210 minutes [24].…”

Section: Discussionmentioning

confidence: 99%

Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery

et al. 2020

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Introduction: The lung is considered a target organ in diabetes mellitus as a consequence of alterations secondary to chronic hyperglycemia that compromise respiratory muscle strength. Metabolic surgery for improving diabetes mellitus has beneficial effects on weight loss and glucose metabolism. Objective: The objective of this study was to evaluate the respiratory muscle strength, assessed by MIP and MEP, body mass index (BMI) and fasting glucose profile of patients with type 2 diabetes mellitus before and after metabolic surgery without gastric resection. Method: Seventeen patients with type 2 diabetes mellitus participated in the study. The participants had a mean age of 44.8 ± 11.81 years. Results: The results showed a significant decrease of MEP values in the immediate postoperative period when compared to the preoperative period (p=0.001), while no significant results were obtained for MIP. Regarding BMI and fasting glucose, significant weight loss and a significant reduction in fasting glucose levels were observed in the late postoperative period (p=0.006 and p=0.007, respectively). Conclusion: The MIP and MEP were reestablished and satisfactory results were obtained for BMI and fasting glucose in the late postoperative period. Further studies are needed to monitor patients in the pre- and postoperative period of metabolic surgery, identifying complications and acting on the care and recovery of these patients.

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The use of flumazenil for benzodiazepine associated respiratory depression in postanesthesia recovery: risks and outcomes

Cited by 5 publications

References 19 publications

Altered Behavioral Responses Show GABA Sensitivity in Muscleblind-Like 2-Deficient Mice: Implications for CNS Symptoms in Myotonic Dystrophy

Altered Behavioral Responses Show GABA Sensitivity in Muscleblind-Like 2-Deficient Mice: Implications for CNS Symptoms in Myotonic Dystrophy

Remimazolam tosilate in patients undergoing upper gastrointestinal endoscopy: a multicenter, randomized, dose-exploration, positive-controlled, parallel-group, phase II trial

Pre- and postoperative respiratory muscle strength, body mass index and fasting glucose profile of patients with type 2 diabetes mellitus submitted to metabolic surgery

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