Effect of flumazenil on recovery from sevoflurane anesthesia in children premedicated with oral midazolam before undergoing herniorrhaphy with or without caudal analgesia

Araki, Hiromi; Fujiwara, Yoshihiro; Shimada, Yasuhiro

doi:10.1007/s00540-005-0314-4

Cited by 17 publications

(10 citation statements)

References 20 publications

(27 reference statements)

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“…One new RCT corroborates findings reported in the original Guidelines regarding the efficacy of flumazenil to antagonize (i.e., reduced time to emergence) the residual effects of benzodiazepines after general anesthesia (Category A3-B evidence), 70 when compared with placebo. The original Guidelines also indicated that flumazenil reduces time to emergence after sedation (Category A1-B evidence); new literature is insufficient to further evaluate these findings.…”

Section: Antagonism Of the Effects Of Sedatives Analgesics And supporting

confidence: 72%

Practice Guidelines for Postanesthetic Care

et al. 2013

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Section: Antagonism Of the Effects Of Sedatives Analgesics And supporting

confidence: 72%

Practice Guidelines for Postanesthetic Care

et al. 2013

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“…A recent CCT 79 Guidelines 17 claimed that flumazenil reduced the time to emergence following sedation (Evidence A1-B). Experts 17 disagree on the routine use of flumazenil to reduce the number of adverse events or improving patient comfort and satisfaction.…”

Section: Benzodiazepines Antagonistic Activitymentioning

confidence: 99%

Evidence-based clinical practice manual: Postoperative controls

Benavides

Alvarado

Torres

et al. 2015

Colombian Journal of Anesthesiology

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a b s t r a c t Introduction: Post-anesthetic care reduces the anesthesia-related postoperative complications and mortality, shortens the length of stay at the postoperative care units and improves patient satisfaction.Objective: To establish a set of recommendations for immediate post-anesthetic care of patients that received general/regional anesthesia or profound/moderate sedation at the postoperative care units.Methodology: This is a process of "rapid" clinical practice guidelines adaptation, including systematic search. The illegible guidelines for adaptation were rated using AGREE II. The guideline selected to be adapted as the clinical practice handbook was Practice guidelines for post-anesthetic care of the American Society of Anesthesiologists. The manual was evaluated in terms of implementation ability, up-to-date information, relevancy, ethical considerations and patient safety by the group of anesthesiologists and epidemiologists based on Delphi. Result:The manual kept the recommendations on evaluation and monitoring, pharmacological management of postoperative nausea and vomiting, antagonistic actions for sedatives and analgesics and neuromuscular block agents, emergency management and anesthesia recovery, as well as the criteria for discharge from the unit. Indications about the conditions and requirements of the unit and patient admission were also included.

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“…Some studies have reported that midazolam which acts on its target effect site GABA A , reduces emergence agitation [5,6], and its antagonist, flumazenil reverses this effect [7]. However, the mechanism is still not clear, and it is not known whether sevoflurane and midazolam interact at the GABA A receptor level.…”

mentioning

confidence: 99%