[Diazepam reversion with flumazenil. Gasometric and sympathetic-adrenal study]

We report the effects of flumazenil as reversion agent of the effects of diazepam at high doses as a part of short-duration general anesthesia. We have studied ten women in ASA I general condition who received anesthesia with fentanyl, 2.5 micrograms/kg-1, diazepam, 0.4 mg/kg-1 and O2/N2 at 60%. At the end of the operation, flumazenil, 0.2 mg, was administered. Hemodynamic, respiratory and adrenergic effects were evaluated. The degree of awareness and subjective feeling of the patient at awakening were also evaluated. After administration of flumazenil, awareness state was significantly higher (p less than 0.001) and it persisted during the duration of the study (120 minutes). Respiratory rate and pO2 increased significantly with administration of flumazenil (p less than 0.25 and p less than 0.01, respectively) and pCO2 decreased from 42.2 mmHg to 37.9 mmHg (p less than 0.05). Neither hemodynamic parameters nor plasma concentration of catecholamines changed significantly. As secondary effects attributable to flumazenil, four patients complained of nausea and one patient referred anxiety. We conclude that flumazenil allows to carry out anesthetic techniques with high doses of benzodiazepines even in short duration interventions with safety and without cardiocirculatory nor sympathetic-adrenal alterations.