Tl. Chern et al., THE ROLE OF FLUMAZENIL IN THE MANAGEMENT OF PATIENTS WITH ACUTE ALTERATION OF MENTAL STATUS IN THE EMERGENCY DEPARTMENT, Human & experimental toxicology, 13(1), 1994, pp. 45-50
1 There are a few case reports which suggest that flumazenil can be us
ed as a diagnostic tool in coma of unknown aetiology but no large scal
e studies have proved its efficacy and cost-effectiveness. 2 Fifty fiv
e patients with acute alteration of mental status of unknown aetiology
were enrolled prospectively during a time period of one year. Flumaze
nil was injected intravenously in a regimen of 0.3 mg in the first min
ute followed by alternate 0.2 mg, 0.3 mg doses every minute until a to
tal dose of 1 mg was given or until the patients responded. 3 Patients
were divided into two groups based on their response to flumazenil: G
roup 1, responders and Group 2, non-responders, The hospital stay was
shortened significantly and interventional procedures, such as CT of b
rain and endotracheal intubation, were rendered unnecessary in several
patients in Group 1. The Group 1 patients had a more favourable outco
me than that of Group 2. 4 We concluded that flumazenil may serve as a
useful tool in diagnosis and management of carefully selected patient
s with acute alteration of mental status.