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The role of flumazenil in the management of patients with acute alteration of mental status in the emergency department.

Abstract
There are a few case reports which suggest that flumazenil can be used as a diagnostic tool in coma of unknown aetiology but no large scale studies have proved its efficacy and cost-effectiveness. Fifty five patients with acute alteration of mental status of unknown aetiology were enrolled prospectively during a time period of one year. Flumazenil was injected intravenously in a regimen of 0.3 mg in the first minute followed by alternate 0.2 mg, 0.3 mg doses every minute until a total dose of 1 mg was given or until the patients responded. Patients were divided into two groups based on their response to flumazenil: Group 1, responders and Group 2, non-responders. The hospital stay was shortened significantly and interventional procedures, such as CT of brain and endotracheal intubation, were rendered unnecessary in several patients in Group 1. The Group 1 patients had a more favourable outcome than that of Group 2. We concluded that flumazenil may serve as a useful tool in diagnosis and management of carefully selected patients with acute alteration of mental status.
AuthorsT L Chern, S C Hu, C H Lee, J F Deng
JournalHuman & experimental toxicology (Hum Exp Toxicol) Vol. 13 Issue 1 Pg. 45-50 (Jan 1994) ISSN: 0960-3271 [Print] England
PMID8198829 (Publication Type: Journal Article)
Chemical References
  • Flumazenil
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Coma (therapy)
  • Consciousness
  • Emergency Medical Services
  • Female
  • Flumazenil (therapeutic use)
  • Glasgow Coma Scale
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies

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