keyword
https://read.qxmd.com/read/38353195/intentional-overdose-on-liquid-clonazolam-reversed-with-flumazenil-a-case-report
#1
JOURNAL ARTICLE
Gayle Galletta
INTRODUCTION: Clonazolam is a designer benzodiazepine that can be purchased illicitly on the internet. The use of designer benzodiazepines is increasing in both the United States and abroad, and patients may present to the emergency department (ED) after intentional or non-intentional overdose. CASE REPORT: This case report describes a patient who presented to a community ED after an intentional overdose on liquid clonazolam and was successfully treated with flumazenil...
November 2023: Clinical Practice and Cases in Emergency Medicine
https://read.qxmd.com/read/38205822/comparison-of-recovery-profiles-between-total-intravenous-anaesthesia-with-propofol-or-remimazolam-reversed-with-flumazenil-in-patients-undergoing-breast-surgery-a-randomised-controlled-trial
#2
RANDOMIZED CONTROLLED TRIAL
Jaemoon Lee, Dong Hyouk Kim, Jae-Woo Ju, Karam Nam, Youn Joung Cho, Yunseok Jeon, Seohee Lee
BACKGROUND: Remimazolam, a short acting benzodiazepine, is being used for general anaesthesia. The results of studies comparing recovery after propofol with that of remimazolam are inconsistent. Given that flumazenil reverses the sedative effects of remimazolam, we hypothesised that it would speed up recovery from remimazolam general anaesthesia. OBJECTIVES: The aim of this trial was to compare the speed of recovery from general anaesthesia between propofol and remimazolam reversed with flumazenil in patients undergoing minimally invasive breast surgery...
March 1, 2024: European Journal of Anaesthesiology
https://read.qxmd.com/read/38068368/comparison-of-remimazolam-flumazenil-versus-propofol-for-recovery-from-general-anesthesia-a-systematic-review-and-meta-analysis
#3
REVIEW
Quantong Wu, Fuchao Xu, Jie Wang, Ming Jiang
(1) Purpose: to systematically evaluate the recovery following sedation and anesthesia with remimazolam combined with flumazenil in comparison to propofol. (2) Methods: Electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, were systematically searched from their inception up to 22 October 2023. Included in this analysis were randomized controlled trials (RCT) that compared remimazolam-flumazenil with propofol for the recovery from sedation and anesthesia in adults. The risk of bias was assessed using the Cochrane risk of bias tool...
November 26, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/37986333/remimazolam-based-anesthesia-with-flumazenil-allows-faster-emergence-than-propofol-based-anesthesia-in-older-patients-undergoing-spinal-surgery-a-randomized-controlled-trial
#4
JOURNAL ARTICLE
Yukari Toyota, Takashi Kondo, Kyoko Oshita, Toshiaki Haraki, Soshi Narasaki, Kenshiro Kido, Satoshi Kamiya, Ryuji Nakamura, Noboru Saeki, Yousuke T Horikawa, Yasuo M Tsutsumi
BACKGROUND: Remimazolam is a novel, ultrashort-acting benzodiazepine that can be antagonized by flumazenil. This study aimed to determine whether remimazolam-based anesthesia with flumazenil provides a more rapid emergence than propofol-based anesthesia in older patients undergoing spinal surgery. METHODS: This was a prospective, single-blind, randomized controlled trial. Forty-four patients > 75 years old who had undergone spinal surgery were enrolled in this study...
November 17, 2023: Medicine (Baltimore)
https://read.qxmd.com/read/37727906/remimazolam-and-serious-adverse-events-a-scoping-review
#5
JOURNAL ARTICLE
Sander Kempenaers, Tom G Hansen, Marc Van de Velde
UNLABELLED: Remimazolam is anticipated to be an interesting anaesthetic and sedative. It combines the pharmacodynamic properties of midazolam with pharmacokinetic properties similar to remifentanil. However, worrisome case reports of anaphylaxis, delayed emergence and re-sedation have emerged recently and necessitate further investigation.PubMed (including MEDLINE) and EMBASE were searched for all studies reporting serious adverse events where remimazolam was administered for sedation or anaesthesia...
November 1, 2023: European Journal of Anaesthesiology
https://read.qxmd.com/read/37721023/2023-american-heart-association-focused-update-on-the-management-of-patients-with-cardiac-arrest-or-life-threatening-toxicity-due-to-poisoning-an-update-to-the-american-heart-association-guidelines-for-cardiopulmonary-resuscitation-and-emergency-cardiovascular
#6
REVIEW
Eric J Lavonas, Peter D Akpunonu, Ann M Arens, Kavita M Babu, Dazhe Cao, Robert S Hoffman, Christopher O Hoyte, Maryann E Mazer-Amirshahi, Andrew Stolbach, Maude St-Onge, Trevonne M Thompson, George Sam Wang, Amber V Hoover, Ian R Drennan
In this focused update, the American Heart Association provides updated guidance for resuscitation of patients with cardiac arrest, respiratory arrest, and refractory shock due to poisoning. Based on structured evidence reviews, guidelines are provided for the treatment of critical poisoning from benzodiazepines, β-adrenergic receptor antagonists (also known as β-blockers), L-type calcium channel antagonists (commonly called calcium channel blockers), cocaine, cyanide, digoxin and related cardiac glycosides, local anesthetics, methemoglobinemia, opioids, organophosphates and carbamates, sodium channel antagonists (also called sodium channel blockers), and sympathomimetics...
October 17, 2023: Circulation
https://read.qxmd.com/read/37542050/re-audit-of-the-use-of-flumazenil-following-midazolam-induced-conscious-sedation
#7
JOURNAL ARTICLE
Muhammad Syafiq Asyraf Rosli, Ellie Heidari
INTRODUCTION: Flumazenil is an antagonist drug of Benzodiazepam (BDZ) that has been used as a reversal agent of midazolam-induced conscious sedation (CS) in both emergency and elective procedures. For CS procedure, a high-quality record keeping and clinical justification prior to admission of flumazenil are recommended. Clinical Audit (CA) enables clinicians to evaluate the quality and standard of recorded clinical procedures. METHODS: This re-audit investigated the reasons for the use of flumazenil and record keeping's quality with particular emphasis on CS...
August 4, 2023: BDJ Open
https://read.qxmd.com/read/37506483/comparison-of-propofol-vs-remimazolam-on-emergence-profiles-after-general-anesthesia-a-randomized-clinical-trial
#8
JOURNAL ARTICLE
Eun Jung Oh, Yoon Joo Chung, Jong-Hwan Lee, Eun Jin Kwon, Eun Ah Choi, Young Keun On, Jeong-Jin Min
STUDY OBJECTIVE: The emergence profiles in patients undergoing total intravenous anesthesia with either propofol or remimazolam with flumazenil reversal were compared. DESIGN: A prospective, double-blind, randomized trial. SETTING: An operating room and a post-anesthesia care unit (PACU). PATIENTS: Adult patients (n = 100) having American Society of Anesthesiologists (ASA) physical status of I-III undergoing general anesthesia were enrolled and randomly assigned to the propofol or the remimazolam group...
July 26, 2023: Journal of Clinical Anesthesia
https://read.qxmd.com/read/37482584/successful-reversal-of-remimazolam-anesthesia-in-a-cannot-intubate-can-ventilate-situation-a-case-report
#9
JOURNAL ARTICLE
Shota Sekimoto, Shuya Kiyama, Shoichi Uezono
BACKGROUND: Compared to other intravenous anesthetics, availability of a specific antagonist flumazenil is a clear advantage of remimazolam. We report a patient who could be rapidly woken up when laryngoscopy and tracheal intubation were unexpectedly difficult. CASE PRESENTATION: A 62-year-old man was scheduled to have resection of a small gingival tumor. Preoperative airway examination was unremarkable except for an omega-shaped epiglottis. Anesthesia was induced with remifentanil/remimazolam infusion and rocuronium...
July 24, 2023: JA Clinical Reports
https://read.qxmd.com/read/37481911/systematic-review-with-meta-analysis-of-relative-risk-of-prolonged-times-to-tracheal-extubation-with-desflurane-versus-sevoflurane-or-isoflurane
#10
REVIEW
Franklin Dexter, Bradley J Hindman
The objective of this systematic review was to estimate the relative risk of prolonged times to tracheal extubation with desflurane versus sevoflurane or isoflurane. Prolonged times are defined as ≥15 min from end of surgery (or anesthetic discontinuation) to extubation in the operating room. They are associated with reintubations, naloxone and flumazenil administration, longer times from procedure end to operating room exit, greater differences between actual and scheduled operating room times, longer times from operating room exit to next case start, longer durations of the workday, and more operating room personnel idle while waiting for extubation...
November 2023: Journal of Clinical Anesthesia
https://read.qxmd.com/read/37438459/recovery-of-memory-retention-after-anesthesia-with-remimazolam-an-exploratory-randomized-open-propofol-controlled-single-center-clinical-trial
#11
JOURNAL ARTICLE
Keiko Nobukuni, Kazuhiro Shirozu, Aiko Maeda, Kouta Funakoshi, Midoriko Higashi, Ken Yamaura
PURPOSE: Remimazolam, a newly developed ultra-short-acting benzodiazepine, provides early recovery of consciousness but its effects on memory recovery are unclear. This study examined memory recovery after emergence from general anesthesia using remimazolam. METHODS: Seventy-four patients undergoing breast surgery between October 2021 and March 2022 were enrolled and randomly assigned to receive propofol (control group) or remimazolam as general anesthetic during surgery...
July 13, 2023: JA Clinical Reports
https://read.qxmd.com/read/37436877/phenibut-toxicosis-in-a-dog
#12
Michael Sahagian, Alicia Mastrocco, Jennifer Prittie
OBJECTIVE: To describe the successful treatment of severe neurological and cardiovascular abnormalities in a dog following ingestion of the neuropsychotropic drug, phenibut. CASE SUMMARY: A 2-year-old neutered male Weimaraner was found unresponsive and laterally recumbent in his urine after ingesting approximately 1600 mg/kg of phenibut. On presentation to an emergency clinic, the dog was neurologically inappropriate, tachycardic, hypertensive, and exhibiting a profoundly decreased respiratory rate...
2023: Journal of Veterinary Emergency and Critical Care
https://read.qxmd.com/read/37379088/anesthetic-management-using-remimazolam-in-a-hemodialysis-patient
#13
JOURNAL ARTICLE
Yukiko Nishioka, Saki Miyake, Midori Hamaoka, Kota Miyake, Maki Fujimoto, Hitoshi Higuchi, Takuya Miyawaki
Remimazolam, an ultra-short-acting benzodiazepine, is a new intravenous anesthetic used for sedation and general anesthesia. Because remimazolam is primarily metabolized by carboxylesterases in the liver and other tissues including the lung and has metabolites with little or no bioactivity, its anesthetic effect is not significantly influenced by renal dysfunction. Therefore, remimazolam may be considered an appropriate agent for hemodialysis patients and may have added benefits beyond midazolam and propofol...
June 1, 2023: Anesthesia Progress
https://read.qxmd.com/read/37168262/case-report-a-comatose-patient-with-pregabalin-overdose-successfully-treated-with-continuous-renal-replacement-therapy
#14
Visti Torbjørn Nielsen, Nelun Wijayasinghe, Lotte Christine Groth Høgberg, Søren Bøgevig
Pregabalin (PB) overdose causes mild symptoms and coma is rarely seen unless the patient has also ingested sedatives and/or has preexisting renal disease. We present a case report of a suicide attempt with PB where the patient presented in a comatose state that was successfully treated with continuous renal replacement therapy (CRRT). Treatment of PB overdose is usually supportive. However, previous reports of PB overdose have been treated with intermittent hemodialysis (IHD) in patients with preexisting renal disease...
2023: Frontiers in Medicine
https://read.qxmd.com/read/37131126/comparison-of-the-recovery-profile-of-remimazolam-with-flumazenil-and-propofol-anesthesia-for-open-thyroidectomy
#15
JOURNAL ARTICLE
Ho-Jin Lee, Hyo Bin Lee, Yoon Jung Kim, Hye-Yeon Cho, Won Ho Kim, Jeong-Hwa Seo
BACKGROUND: Previous studies have consistently reported a slower recovery of consciousness following remimazolam-based total intravenous anesthesia without flumazenil than with propofol. This study aimed to compare the reversal effect of flumazenil on the recovery of consciousness after remimazolam-based total intravenous anesthesia with the propofol recovery profile. METHODS: This prospective, single-blinded, randomized trial included 57 patients undergoing elective open thyroidectomy at a tertiary university hospital...
May 2, 2023: BMC Anesthesiology
https://read.qxmd.com/read/37038661/anxiolytic-effects-of-n-4-5-dihydro-5-oxo-1-2-dithiolo-4-3-b-pyrrole-6-yl-n-methylformamide-a-pyrroloformamide-isolated-from-a-marine-streptomyces-sp-in-adult-zebrafish-by-the-5-ht-system
#16
JOURNAL ARTICLE
Hozana Patrícia S de F Cesário, Francisca Crislândia O Silva, Maria Kueirislene A Ferreira, Jane Eire S A de Menezes, Hélcio S Dos Santos, Aluísio Marques da Fonseca, Carlos Emídio S Nogueira, Marcia M Marinho, Emmanuel S Marinho, Alexandre Magno R Teixeira, Edilberto R Silveira, Otília Deusdênia L Pessoa
General anxiety disorders are among the most prevalent mental health problems worldwide. The emergence and development of anxiety disorders can be due to genetic (30-50%) or non-genetic (50-70%) factors. Despite medical progress, available pharmacotherapies are sometimes ineffective or can cause undesirable side effects. Thus, it becomes necessary to discover new safe and effective drugs against anxiety. This study evaluated the anxiolytic effect in adult zebrafish ( Danio rerio ) of a natural pyrroloformamide (PFD), N -(4,5-dihydro-5-oxo-1,2-dithiolo-[4,3,b]-pyrrole-6-yl)- N -methylformamide, isolated from a Streptomyces sp...
April 10, 2023: Journal of Biomolecular Structure & Dynamics
https://read.qxmd.com/read/36872499/multiple-sleep-latency-test-maintenance-of-wakefulness-test-and-central-hypersomnias-evolving-diagnostic-and-therapeutic-approaches
#17
JOURNAL ARTICLE
Ajay C Sampat, Alon Y Avidan
Central disorders of hypersomnolence include a spectrum of conditions, such as narcolepsy, idiopathic hypersomnia, and Kleine-Levin syndrome, in which excessive daytime sleepiness is the primary feature. Subjective testing with tools, such as sleep logs and sleepiness scales, are often helpful in the evaluation of these disorders but do not necessarily correlate well with objective testing, such as polysomnography and multiple sleep latency test and maintenance of wakefulness test. The most recent International Classification of Sleep Disorders-Third Edition has incorporated biomarkers, such as cerebrospinal fluid hypocretin level, into the diagnostic criteria and have restructured the classification of conditions based on our evolved understanding of their underlying pathophysiologic mechanisms...
March 1, 2023: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://read.qxmd.com/read/36572840/anesthetic-management-with-remimazolam-in-a-patient-with-child-pugh-c-liver-cirrhosis-a-case-report
#18
JOURNAL ARTICLE
Satoshi Uchida, Daiki Takekawa, Eiji Hashiba, Reiko Kudo, Kazuyoshi Hirota
BACKGROUND: Remimazolam is a new ultra-short-acting benzodiazepine, and its sedative effect is prolonged in patients with hepatic impairment. This is the first report of remimazolam anesthesia in a patient with Child-Pugh C liver cirrhosis. CASE PRESENTATION: A 52-year-old female was diagnosed with tongue cancer and scheduled for partial glossectomy. Preoperative examinations revealed Child-Pugh C liver cirrhosis, but the pathogenesis was unknown. We scheduled remimazolam anesthesia because it would stabilize her intraoperative circulation...
December 27, 2022: JA Clinical Reports
https://read.qxmd.com/read/36260199/long-term-delayed-emergence-after-remimazolam-based-general-anesthesia-a-case-report
#19
JOURNAL ARTICLE
Tsubasa Takemori, Yoshimasa Oyama, Takenori Makino, Seigo Hidaka, Takaaki Kitano
BACKGROUND: Remimazolam is an ultra-short-acting benzodiazepine anesthetic that is antagonized by flumazenil, and it is typically expected to be applied in anesthesia with the purpose of ensuring early postoperative recovery. We report a case of long-term delayed emergence with re-sedation even after three times of flumazenil administration. CASE PRESENTATION: A 71-year-old man was scheduled for a robotic-assisted laparoscopic radical prostatectomy for prostate cancer...
October 19, 2022: JA Clinical Reports
https://read.qxmd.com/read/36249602/availability-of-antidotes-for-management-of-acute-toxicity-cases-at-emergency-departments-in-qassim-hospitals-a-retrospective-study
#20
JOURNAL ARTICLE
Mahdi H Alsugoor
BACKGROUND: Drug overdose is a medico-social issue worldwide that may occur intentionally or unintentionally. It is one of the most common reasons for emergency department visits, and it is also a frequent cause of morbidity and mortality globally. This study aims to determine the occurrence of acute toxicity cases and their management outcomes at the emergency departments in Qassim Province hospitals in Saudi Arabia. In addition, the study aims to investigate the antidote availabilities at those medical centers...
September 2022: Curēus
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