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The Role of Flumazenil in the Management of Patients With Acute Alteration of Mental Status in the Emergency Department

Emergency Room, Lotung St Mary's Hospital, Veterans General Hospital, Taipei, Taiwan

Sheng-Chuan Hu

Emergency Department, Veterans General Hospital, Taipei, Taiwan

Chen-Hsen Lee

Emergency Department, Veterans General Hospital, Taipei, Taiwan

Jou-Fang Deng

Emergency Department, Veterans General Hospital, Taipei, Taiwan

1 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.

2 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.

3 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.

4 We concluded that flumazenil may serve as a useful tool in diagnosis and management of carefully selected patients with acute alteration of mental status.

Human & Experimental Toxicology, Vol. 13, No. 1, 45-50 (1994)
DOI: 10.1177/096032719401300107


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