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

  • Domingos Dias Cicarelli a. Department of Anesthesiology, Hospital Universitário, University of São Paulo, Brazil. b. Department of Anesthesiology, Hospital das Clinicas, Faculdade de Medicina, University of São Paulo, Brazil
  • Nora Elizabeth Rojas-Álvarez Department of Anesthesiology, Hospital das Clinicas, Faculdade de Medicina, University of São Paulo, Brazil
  • Priscila Fuller Department of Anesthesiology, Hospital das Clinicas, Faculdade de Medicina, University of São Paulo, Brazil
  • Marcelo Lacava Pagnocca a. Department of Anesthesiology, Hospital Universitário, University of São Paulo, Brazil. b. Department of Anesthesiology, Hospital das Clinicas, Faculdade de Medicina, University of São Paulo, Brazil
  • Elke Frerichs Department of Anesthesiology, Hospital Universitário, University of São Paulo, Brazil
  • Fábio Ely Martins Bensenor a. Department of Anesthesiology, Hospital Universitário, University of São Paulo, Brazil. b. Department of Anesthesiology, Hospital das Clinicas, Faculdade de Medicina, University of São Paulo, Brazil
Keywords: Randomized controlled trials as topic, Isoflurane, Flumazenil, Anesthesia general, GABA Receptors

Abstract

Background and objectives: The inhalational anesthetic isoflurane is widely used in general anesthetics. Its mechanism of action involves interaction with the receptor of gamma-aminobutyric acid (GABA), which is also the binding site for benzodiazepines. Flumazenil, benzodiazepine antagonist, reverses the effects of these drugs in GABA receptors and could therefore also reverse the effect of isoflurane. In anesthesia practice, extubation and early anesthetic recovery reduce morbidity and incidence of complications. The objective of this trial is to determine whether the use of lumazenil may contribute to faster recovery from anesthesia.

Methods: Forty patients scheduled to undergo general anesthesia with isolurane were enrolled in this prospective, double-blind, randomized trial. Patients were randomized to receive, at the end of anesthesia, lumazenil or placebo as allocated into two groups. The anesthetic technique was standardized. The groups were compared concerning values of cerebral state index (CSI), heart rate, blood pressure and oxygen saturation from the application of flumazenil or placebo until 30 min after injection. Data regarding time to extubation, time to reach 10 points in the Aldrete-Kroulic score (AK = 10) and Vigilance score (VS = 10) was also collected. ANOVA test was applied to analyze the results, considering < 0.05. Results:Patients receiving flumazenil achieved faster extubation than the control (p = 0.033). No differences were observed in values of CSI, the time until AK = 10 and until VS = 10.

Conclusions: Administration of lumazenil at the end of isolurane general anesthesia resulted in earlier extubation in studied patients.

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How to Cite
1.
Dias Cicarelli D, Rojas-Álvarez NE, Fuller P, Lacava Pagnocca M, Frerichs E, Martins Bensenor FE. Effect of flumazenil on recovery from general anesthesia with isoflurane: A randomized controlled trial. Colomb. J. Anesthesiol. [Internet]. 2016 Jan. 1 [cited 2024 Mar. 28];44(1):8-12. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/59

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Published
2016-01-01
How to Cite
1.
Dias Cicarelli D, Rojas-Álvarez NE, Fuller P, Lacava Pagnocca M, Frerichs E, Martins Bensenor FE. Effect of flumazenil on recovery from general anesthesia with isoflurane: A randomized controlled trial. Colomb. J. Anesthesiol. [Internet]. 2016 Jan. 1 [cited 2024 Mar. 28];44(1):8-12. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/59
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