Comparison of the recovery characteristics of midazolam, alone or antagonised with flumazenil, and thiopental in ASA III-IV patients.

Abstract

Sixty non-premedicated male patients, physically ASA III-IV, 50-80 years of age, undergoing translumbar aorthography, were randomly allocated into three groups. Group A received midazolam (0.13 mg.kg-1), group B received thiopental (4 mg.kg-1), and group C midazolam (0.13 mg.kg-1) combined with flumazenil (6 micrograms.kg-1) at the end of the operation. Three minutes before the anaesthesia began, fentanyl (1.5 micrograms.kg-1) was administered to all the patients. An evaluation was made of the time they took to open their eyes spontaneously, of time-space orientation, comprehension-collaboration, hypnosedation, psychomotor performance and memory. In groups "C" and "B" spontaneous opening of the eyes took place before that of group "A". The recovery of orientation, comprehension and hypnosedation was fastest with thiopental, next with midazolam combined with flumazenil, and later with midazolam. Psychomotor performance in Trieger test was impaired for a shorter period with thiopental than in the other two groups. Recovery in group "C" was incomplete within the time, with the result that resedation was detected in 20% of the subjects.