Drug Design, Development and Therapy (Mar 2024)
Clinical Study of Flumazenil Antagonizing Remimazolam on Nausea and Vomiting After Gynecologic Day Surgery
Abstract
Yaxin Wei,1 Min Zhu,2 Yan Man,1 Hongyi Xiao,3 Guimin Dong,3 Xinyuan Shi,1 Fanceng Ji3 1School of Anesthesiology, Weifang Medical University, Weifang, 261053, People’s Republic of China; 2Department of Gynecology, Weifang People’s Hospital, Weifang, 261041, People’s Republic of China; 3Department of Anesthesiology, Weifang People’s Hospital, Weifang, 261041, People’s Republic of ChinaCorrespondence: Fanceng JiDepartment of Anesthesiology, Weifang People’s Hospital, No. 151 Guangwen Street, Kuiwen District, Weifang, 261041, People’s Republic of China, Tel +86-13563698838, Email [email protected]: To evaluate the effect of flumazenil antagonizing remimazolam on postoperative nausea and vomiting (PONV) after gynecologic day surgery.Patients and Methods: 141 cases of gynaecological daycase surgery patients in Weifang People’s Hospital were selected, randomized into group F (flumazenil group, 71 cases) and group C (control group, 70 cases). Dexamethasone 5 mg, flurbiprofen axetil 50 mg, and droperidol 1 mg were given intravenously before induction of anesthesia in both groups. Anesthesia induction: Remimazolam 0.25mg / kg was injected within 1 minute. After the patient fell asleep, mivacurium chloride 0.2mg / kg was injected for 30 seconds and alfentanil 20ug / kg was injected for 30 seconds. Anesthesia maintenance: Remimazolam 1mg/kg/h and alfentanil 40ug/kg/h were continuously pumped by micro pump. Stopping the injection of remimazolam and alfentanil at the end of the operation. Flumazenil 0.2 mg was given to antagonize remimazolam in group F after 1 minute. Group C was given an equal volume of saline. The incidence of PONV in the postoperative PACU and over a 24-hour period, patient awakening time, and general patient information were recorded.Results: The incidence of PONV in both groups within 24 hours was 50.70% in group F was significantly higher than 32.86% in group C. The difference was statistically significant (P < 0.05). The incidence of PONV in the PACU was 5.6% in group F and 8.6% in group C. The difference was not statistically significant (p > 0.05).Conclusion: Flumazenil antagonism of remimazolam increases the incidence of PONV within 24 hours in gynecologic day surgery patients and has no significant effect on the incidence of PONV in the PACU.Keywords: flumazenil, remimazolam, gynecologic day surgery, postoperative PONV
