| Popis: |
Aim of the study is to assess the efficacy of flumazenil when used for recovery after midazolam-induced sedation in short acting, out-patient procedure like interruption of early pregnancy. A significantly faster recovery of the patients after injection of flumazenil was observed. When flumazenil was not used, patients remained drowsy, worse oriented, and less co-operative at 1.5 and 20 min after completion of abortion. There were no significant difference between the groups with and without flumazenil at the 60 min. In conclusion when it is possible to observe the patients for more than one hour, the application of flumazenil after sedation with midazolam is not necessary.In a comparative study, the efficacy of flumazenil, when used for recovery after midazolam-induced sedation for outpatient procedures, was assessed in two groups of women undergoing early termination of pregnancy at a university maternity ward. The 1st group of 32 women received flumazenil immediately after the procedure, while the 2nd group did not. The 2nd group consisted of 30 women who underwent early abortion (10-11 weeks). Their average age was 29.9 years (range, 18-42 years); their weight averaged 60.6 kg (range, 43-72 kg). Premedication consisted of 0.5 mg of venous atropine. The average dose of anesthesia with midazolam amounted to 15.08 mg per patient. The patients fell asleep within 1-3 minutes after receiving the drug (average, 1.87 minutes). The average time of awakening was 6.6 minutes (range, 2-20 minutes). The average duration of the procedure was 5.45 minutes (range, 3-14 minutes). Awakening and getting up were evaluated according to the modified scheme of Stewart after 1, 5, 20, and 60 minutes. Phase 1 meant that the patient did not open her eyes and did not react to a command; Phase 2 occurred when the patient opened her eyes and responded to the command; Phase 3 occurred when the patient was in light sleep and moments later opened her eyes; and Phase 4 occurred when the patient fully awakened, opened her eyes, and began to talk. Correlation analysis showed a significant reverse relationship between the speed of recovery after administration of midazolam and the administration of flumazenil at 5 minutes (r = - 0.8) and at 20 minutes (r = - 0.9), but at 60 minutes the differences were evened out (r = - 0.32). When flumazenil was not used the patients remained drowsy at 1, 5, and 20 minutes after completion of abortion. When the patients can be observed for more than 1 hour, the administration of flumazenil after sedation with midazolam is not necessary. |
