Akademik Veri Yönetim Sistemi
Turk Anesteziyoloji ve Reanimasyon, cilt.23, sa.4, ss.208-210, 1995 (Scopus)
Flumazenil is a competitive benzodiazepine antagonist. A case of cardiac arrest following administration of flumazenil for reversal of midazolam, is reported. A 50 years old man with complaints of fatigue and dizziness admitted to our hospital. After the coin lesions shown on chest x-ray, a lung biopsy was planned. Midazolam 15 mg and vecuronium 0.06 mg/kg was used for induction. Anaesthesia was maintained with halothane 0.5-1 % in N2O/O2 (50 % / 50 %). At the end of the operation neuromuscular blockade was reversed with neostigmine. However, the patient remained disoriented. In order to antagonise the effect of midazolam, 0.2 mg of IV flumazenil was administered slowly. Two minutes after flumazenil, the patient developed cardiac arrest. We thought that this effect would have been due to flumazenil. After resuscitation he regained normal blood pressure, heart rate, ECG and central venous pressure values. Six hours after resuscitation, the patient was extubated without any complications. The efficacy of flumazenil for antagonism of benzodiazepines is certain. However its effectiveness in reversing benzodiazepine induced respiratory depression is less clear. In recent reports a number of fatal arrhythmias and even deaths occurred after administration of flumazenil. The discussion can be made whether this is the direct cardiac effect of flumazenil or not.