The "reference" for not using it routinely is cost. However, I do use it if
clinically indicated or if we are short of nursing staff to recover the
patient. I've never had a problem with patients re-sedating after a bolus of
midazolam reversed by flumazenil.
Ray McGlone
A&E Lancaster
----- Original Message -----
From: <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, October 15, 2001 2:43 PM
Subject: Flumazenil, Sedation and Fits
> Recently while reducing bilateral shoulder 'erecta' dislocations (don't
ask)
> under a bit of Midazolam and opiate I was challenged by a colleague as why
I
> was not wanting to use Flumazenil to simply reverse the Midaz as soon as
the
> procedure was over.
> I gave the standard 'Fit Risk' answer but was then asked to prove it....
> So trying to be the good evidence based practitioner i went to Medline and
searched
> around the subject. To my surprise their are papers that not only document
Flumazenil
> causing fits, usually in relation to mixed ODs, but several advocating its
USE
> as an ANTI-epileptic ( Oral flumazenil in the treatment of epilepsy.
Annals
> of Pharmacotherapy.29(5):530-1,1995May Reisner-Keller LA et al)
> So does anyone have a reference/evidence for why we don't use it for
simply
> waking uncomplicated sedated patients up?
> Cheers
> Peter A Cutting
>
>
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