Korean Journal of Gastrointestinal Endoscopy 2008;36(4): 206-212.
Midazolam을 사용한 의식하 진정 내시경에서 Flumazenil의 투여가 회복시간 및 내시경 만족도에 미치는 영향
김대겸ㆍ정훈용*ㆍ고효미ㆍ조지윤ㆍ김석균ㆍ이돈ㆍ장혜숙ㆍ송혜경ㆍ이현주ㆍ정은주ㆍ박혜원ㆍ김진호*
서울아산병원 건강증진센터 건강의학과, *울산대학교 의과대학 서울아산병원 소화기내과
The Effects of Flumazenil on the Recovery Time and Satisfaction of the Use of Sedative Endoscopy with Midazolam
Dae-Kyoum Kim, M.D., Hwoon-Yong Jung, M.D.*, Hyo Mi Ko, R.N., Ji Yun Jo, M.D., Seog Gyun Kim, M.D., Don Lee, M.D., Hye-Sook Chang, M.D., Hye-Kyung Song, M.D., Hyun Ju Lee, M.D., Eun Ju Chung, M.D., Hye Won Park, M.D. and Jin Ho Kim, M.D.*
Department of Health Medicine, Health Promotion Center, Asan Medical Center, *Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Abstract
Background/Aims: Treatment with flumazenil results in rapid reversal from sedation. In addition, the use of flumazenil can prevent accidents or memory loss after endoscopy. This study was conducted to evaluate the role of flumazenil according to dose. Methods: A total of 150 consecutive outpatients were randomly allocated into three groups: patients given normal saline (control group), patients given 0.25 mg flumazenil (0.25 mg flumazenil group) and patients given 0.5 mg flumazenil (0.5 mg flumazenil group). Flumazenil or normal saline was injected 10 minutes after the completion of endoscopy. We evaluated the recovery time, time to discharge, patient satisfaction, and memory loss after discharge. Results: The control group consisted of 44 subjects, the 0.25 mg flumazenil group consisted of 46 subjects and the 0.5 mg flumazenil group consisted of 45 subjects. The recovery time was significantly shorter in the two flumazenil groups as compared to the control group (28.5±15.0 min, 13.8±3.7 min, 12.4±1.7 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively)(p<0.001). The time to discharge after an examination was shorter in the flumazenil groups and showed dose-dependency (41.2±20.5 min, 22.1±10.9 min, 16.4±2.2 min for the control group, 0.25 mg flumazenil group and 0.5 mg flumazenil group, respectively) (p<0.001). There was no significant difference in patient satisfaction among the three groups. The degree of memory recall was better in the 0.5 mg flumazenil group than in the other two groups (p<0.001). Conclusions: Flumazenil reversal of midazolam sedative endoscopy results in fast recovery and is helpful to minimize memory loss after an examination without interference of satisfaction. (Korean J Gastrointest Endosc 2008;36:206-212)