Does Flumazenil effect the anesthetic agents other than benzodiazepines?: Case report [Flumazenil benzodiazepinler dişindaki anestezik ajanlari da etkiler mi?: Olgu sunumu]
Flumazenil is an imidazobenzodiazepine which is used to reverse sedative and hypnotic effects of benzodiazepines. Although reversing effect of Flumazenil on other anesthetic drugs has been published in the recent studies the mechanism is still unknown. In this case report we present our experience in two patients who unexpectedly recovered from anesthesia following Flumazenil administration. Two male patients respectively at the age of 18 and 19 evaluated as ASA I in preoperative examination, were operated for tonsillectomy, adenoidectomy and septorhinoplasty. One of them was given Midazolam (1 mg iv) as premedication 30 minutes before the operation. Both patients received the same anesthesia induction method (Propofol, Fentanyl) and agents used for maintanence of anesthesia (Sevoflurane, Remifentanil) were identically same. At the end of the operation Atropine and Neostigmine were aplied to the patients to reverse neuromuscular blockers. Signs of recovery from anesthesia were not observed even after more than half an hour period. Flumazenil (0,5 mg iv) were used since there were no any possible reasons to explain this clinical manifestation. In both patients spontaneous eye opening and recovery of respiration were recorded after about a few minutes following Flumazenil administration. Our experience related to these two patients puts forward Flumazenil administration as an unignorable option in delayed recovery from anesthesia and the mechanism behind this phenomenon is worth to proceed further studies.