Endotracheal flumazenil: A new route of administration for benzodiazepine antagonism

The purpose of this study was to determine if flumazenil is absorbed from broncho-pulmonary tissue after intratracheal administration and whether therapeutically significant plasma concentrations can be obtained. Six elective surgical patients received a dose of 1.0 mg flumazenil in 10 mL saline int...

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Bibliographic Details
Published in:The American journal of emergency medicine 1998-03, Vol.16 (2), p.170-172
Main Authors: Palmer, Robert B, Mautz, Douglas S, Cox, Kathy, Kharasch, Evan D
Format: Article
Language:English
Subjects:
Absorption
Administration, Inhalation
Adolescent
Adult
Aged
Anesthesia, General
Anti-Anxiety Agents - antagonists & inhibitors
Antidotes - administration & dosage
Antidotes - adverse effects
Antidotes - analysis
Antidotes - pharmacokinetics
benzodiazepine
Benzodiazepines - antagonists & inhibitors
Biological and medical sciences
Bronchi - metabolism
Chest Pain - prevention & control
Dyspnea - prevention & control
Elective Surgical Procedures
endotracheal
Female
Flumazenil
Flumazenil - administration & dosage
Flumazenil - adverse effects
Flumazenil - blood
Flumazenil - pharmacokinetics
Follow-Up Studies
GABA Modulators - administration & dosage
GABA Modulators - adverse effects
GABA Modulators - blood
GABA Modulators - pharmacokinetics
Gabaergic and benzodiazepinic system
Gas Chromatography-Mass Spectrometry
Humans
intratracheal
Intubation, Intratracheal
Lung - metabolism
Male
Medical sciences
Middle Aged
Neuropharmacology
Neurotransmitters. Neurotransmission. Receptors
overdose
Pharmacology. Drug treatments
Time Factors
Trachea
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Summary:The purpose of this study was to determine if flumazenil is absorbed from broncho-pulmonary tissue after intratracheal administration and whether therapeutically significant plasma concentrations can be obtained. Six elective surgical patients received a dose of 1.0 mg flumazenil in 10 mL saline intratracheally during general anesthesia. Blood samples were drawn for 6 hours after administration and plasma concentrations were determined by gas chromatography-mass spectrometry (GC-MS). An average peak plasma flumazenil concentration of 65.9 ± 43.1 ng/mL was attained within 1 minute after administration. No patients reported chest discomfort or dyspnea upon awakening and there were no other side effects noted. Administration of flumazenil via an endotracheal tube results in rapid attainment of therapeutic blood levels.
ISSN:0735-6757
1532-8171
DOI:10.1016/S0735-6757(98)90039-0