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A randomised crossover trial of post-operative cognitive and psychomotor recovery from benzodiazepine sedation: Effects of reversal with flumazenil over a prolonged recovery period

Lookup NU author(s): Professor Nick Girdler, John Lyne

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Abstract

Objective: To study the post-operative cognitive and psychomotor recovery from midazolam conscious sedation, after reversal with the benzodiazepine antagonist flumazenil over a prolonged recovery period. Design: A prospective, double-blind, randomised, crossover trial. Setting: Out-patient Sedation Department, Newcastle Dental Hospital and School Method: Eighteen patients, ASA I or II, received midazolam on two separate occasions to undergo equivalent dental treatment Following treatment patients were reversed with intravenous flumazenil or saline [placebo] at alternate appointments. Assessment of mood and cognitive function was undertaken using a highly sensitive and specific computerised battery of cognitive tests administered by telephone. Cognitive and psychomotor tests were administered prior to sedation and every hour for 6 hours post reversal. Results: Results indicated no significant effect of flumazenil on simple reaction time and choice reaction time but did show a trend of reversing the effects of midazolam on numeric working memory and word recognition. Conclusion: The cognitive and psychomotor effects of the sedation were not fully reversed by flumazenil. Cognitive impairments were still present up to 6 hours post-reversal, despite patients appearing clinically more alert. This has important implications for treatment protocols and discharge instructions.

Publication metadata

Author(s): Girdler NM; Lyne JP; Fairbrother KJ; Neave N; Scholey A; Hargaden N; Wesnes KA; Engler J; Rotherham NA

Publication type: Article

Publication status: Published

Journal: British Dental Journal

Year: 2002

Volume: 192

Issue: 6

Pages: 335-339

ISSN (print): 0007-0610

ISSN (electronic): 1476-5373

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/sj.bdj.4801369

DOI: 10.1038/sj.bdj.4801369

PubMed id: 15552071

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