Flumazenil Failed to Rapidly Terminate Midazolam Anesthesia in an Opiate Addict

Abstract

AbstractDuring the course of a rapid opiate detoxification procedure, withdrawal symptoms in opiate addicts caused by the application of naloxone were suppressed by an anesthesia induced by the short-acting benzodiazepine midazolam. This anesthesia usually can be easily and rapidly terminated by the administration of the benzodiazepine receptor antagonist flumazenil. In the presented case, relatively high doses of midazolam had to be administered in order to suppress agitation of the patient during anesthesia. Low doses of flumazenil failed to immediately terminate midazolam anesthesia. However, the patient awoke 45 minutes later after he had received a total of 10 mg flumazenil. Possible explanations for this failure of flumazenil to immediately antagonize midazolam anesthesia are discussed.