COMPARISON OF FLUMAZENIL WITH AMINOPHYLLINE TO ANTAGONIZE MIDAZOLAM IN ELDERLY PATIENTS

We have compared, in a double-blind study, the efficacy of flumazenil with that of aminophylline in antagonizing the effects of midazolam in 60 patients (ASA l–II, mean age 66 yr) undergoing transurethral resection of prostate under spinal anaesthesia. All patients received midazolam 0.075 mg kg−1 i.v. and the test drugs were given 5 min after its administration. Patients were allocated randomly to receive i.v. flumazenil 0.01 mg kg−1, aminophylline 2 mg kg−1 or placebo saline 0.1 ml kg−1. One minute after administration, aminophylline caused 42 % reversal of sedation, 66% of disorientation and 73% of lack of co-operation in comparison with placebo, although there was marked individual variation. Flumazenil caused complete and rapid antagonism of sedation, disorientation and lack of cooperation.