Antagonism of diazepam sedation by flumazenil

Forty adult patients undergoing elective surgery, anaesthetized with diazepam, alfentanil and nitrous oxide in oxygen, and paralysed with atracurium were given flumazenil or placebo i.v. in a double-blind randomized study to assess the efficacy of flumazenil. Awake state, heart rate, arterial pressure, rate of ventilation and arterial blood-gas values were measured at 0, 5, 30, 120 and 240 min after administration of flumazenil or placebo. Flumazenil was found to antagonize the sedative effects of diazepam; there was no resedation within the time of observation. There were no intergroup differences in any of the other measured variables. A median dose of diazepam 0.33 mg kg-1 during surgery lasting a median of 98 min was antagonized by a median dose of flumazenil 0.35 mg. No side effects related to flumazenil were observed.