[Effects of injectable flunitrazepam on hepatic and cardiac output in man]

The effects of intravenous flunitrazepam (0.03 mg X kg-1) on the estimated hepatic plasma output (DPHE), compared with the cardiac output (Q), were studied before its injection and 1 min afterwards. The question asked was whether the decrease in venous return led to a fall in hepatic perfusion. This study was made on patients in neurological coma without any organic lesion. The DPHE was measured by applying Fick's principle, using a continuous infusion of indocyanine green (ICG). The DPHE was given by the amount of ICG perfused in mg X min-1 divided by the arterial concentration of ICG less the concentration of ICG in the hepatic vein (in mg X 1(-1)). Cardiac output was measured by thermodilution. Flunitrazepam did not significantly modify either DPHE or Q; they fell by 5.6% and 3.4% respectively. None of the seven cardiovascular parameters changed during the time of the study. Thus, in unconscious patients with satisfactory haemodynamic conditions prior to the intravenous injection, flunitrazepam did not significantly modify hepatic perfusion.