[Sedation in endoscopic diagnosis: rationale of the use of specific benzodiazepine antagonists].

The aim of this study was to evaluate the best clinical use of Flumazenil, a specific antagonist of benzodiazepines, during endoscopic exams. Two-hundred patients were studied: 120 were treated with Flumazenil and 80 with placebo. The patients were prepared for the endoscopic exam with local anaesthesia and i.v. Diazepam administration. Controls performed at the end of the exam and at 5, 30, 120 e 240 minutes from the administration of Flumazenil and placebo, allowed to evaluate the state of awakeness, the level of conscience and the capacity of time-space orientation. Significantly statistical differences between the two groups were obtained at 5, 30 and 120 minutes after Flumazenil administration, while both groups had retrograde amnesia. The drug was well tolerated and there were no undesiderable side effects or reactions. The Authors therefore affirm that Flumazenil, in virtue of its competitive action toward benzodiazepine receptors, interrupts sedation with immediate awakening and improvement of the state of consciousness. Such drug, thus, permits the Day Hospital performance of endoscopic procedures which otherwise would require hospitalization, at the same time allowing the surgeon to use benzodiazepines at doses more adequate for surgical necessities.