Effect of flumazenil on recovery from general anesthesia with isoflurane: A randomized controlled trial

Cicarelli, Domingos Dias; Rojas-Álvarez, Nora Elizabeth; Fuller, Priscila; Pagnocca, Marcelo Lacava; Frerichs, Elke; Benseñor, Fábio Ely Martins

doi:10.1016/j.rcae.2015.06.004

Cited by 2 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In clinical scenarios, the administration of flumazenil would likely be performed after discontinuation of inhalant anaesthesia, that is when the horse has already been placed in the recovery stall. The neuropharmacological interaction between flumazenil and volatile anaesthetics is further complicated by physiologic factors, such as the blood‐brain barrier 19,20,36–39,41 . The continued influence of the inhalant anaesthetic in this study may have altered the impact of flumazenil administration on central nervous system, skeletal muscle and diaphragm activities.…”

Section: Discussionmentioning

confidence: 93%

“…The neuropharmacological interaction between flumazenil and volatile anaesthetics is further complicated by physiologic factors, such as the blood-brain barrier. 19,20,[36][37][38][39]41 The continued influence of the inhalant anaesthetic in this study may have altered the impact of flumazenil administration on central nervous system, skeletal muscle and diaphragm activities. A major limitation of this study is that plasma concentrations of midazolam and flumazenil were not obtained.…”

Section: Discussionmentioning

confidence: 94%

“…Reduced recovery times with flumazenil have been documented in other species. 12,18,20,35,36 In addition to shorter recovery time, earlier resumption of motor activity 35 and earlier time to extubation 36,37 have been observed. The documented enhanced MV, causing a faster elimination of isoflurane and hence emergence from general anaesthesia, may at least in part explain the shorter recovery period.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The effects of flumazenil on ventilatory and recovery characteristics in horses following midazolam‐ketamine induction and isoflurane anaesthesia

Douglas

Hopster

Cerullo

et al. 2020

Equine Veterinary Journal

View full text Add to dashboard Cite

Background: Flumazenil antagonises the actions of benzodiazepines. There has been no prior research specifically investigating this anaesthetic reversal agent for horses.Objectives: To determine the effects of flumazenil administration in horses on (a) ventilatory parameters after midazolam-ketamine induction and maintenance with isoflurane in oxygen and on (b) the characteristics of recovery from general anaesthesia.Study design: Blinded, randomised, crossover experiment.Methods: Six horses were randomly assigned to receive high-dose flumazenil (F high , 20 µg/kg), low-dose flumazenil (F low , 10 µg/kg) and saline (control). Cardioventilatory parameters were monitored. After 90 minutes of isoflurane anaesthesia, a bolus of F high , F low or saline was administered i.v. The horses were recovered using head and tail rope assistance. The times to first movement, to achievement of sternal recumbency, to the first attempt to stand and the total recovery time were determined.The recovery quality was evaluated using a 115-point recovery scoring system. The cardioventilatory parameters and recovery times were analysed using mixed-effects regression analyses. Intraclass correlation (ICC) analysis was used to evaluate the recovery scores. A Mann-Whitney U test assessed the relationship between recovery score and flumazenil administration.Results: A significant difference with flumazenil administration was found for SpO 2 , mean arterial pressure, I:E ratio, minute volume of ventilation (MV) and peak inspiratory pressure. There was a significant difference with flumazenil administration for the time to sternal recumbency, the time to the first attempt to rise and the total recovery time. There was no significant difference in total recovery score with flumazenil administration.Main limitations: Plasma levels of midazolam and flumazenil were not obtained.Conclusions: Flumazenil has a dose-dependent effect on MV and recovery time, which may make it useful in cases for which a prolonged anaesthetic recovery is undesirable.

show abstract

Section: Discussionmentioning

confidence: 93%