[The use of flunitrazepam in ICU patients (author's transl)]

Flunitrazepam exhibits principally the same effects as other benzodiazepines, i.e. sedation, sleep induction, amnesia and muscle relaxation. These effects are maintained for several hours and are additive to those of other drugs, e.g. narcotic analgesics. When flunitrazepam is used in ICU patients its long duration of action and depressant influence on the respiration have to be taken into account. Therefore it is preferred in cases with severe cerebral trauma, prolonged sepsis, or tetanus requiring long-term respiratory treatment. The mean single dose is 1.0 mg and the interval between consecutive doses is, on average, 2 to 3 hours. After prolonged use of flunitrazepam, at least 24 to 48 hours are necessary for sedation and muscle relaxation to disappear to such an extent that transition from mechanical to spontaneous ventilation is possible. Severe side-effects, e.g. cardiac arrhythmias, metabolic disturbances, impairment of renal function, changes in electrolyte or acid-base balance, have not been observed. Peripheral vasodilation is common and may lead to a decrease in arterial blood pressure.