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March 1998Volume 16, Issue 2, Pages 170–172
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Endotracheal flumazenil: A new route of administration for benzodiazepine antagonism☆

Robert B Palmer
x
Robert B Palmer
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Affiliations

  • From the Department of Medicinal Chemistry, University of Washington Seattle, WA. USA
, PhD
,
Douglas S Mautz
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Douglas S Mautz
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Affiliations

  • the Department of Anesthesiology, University of Washington Seattle, WA. USA
, PhD
,
Kathy Cox
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Kathy Cox
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Affiliations

  • the Department of Anesthesiology, University of Washington Seattle, WA. USA
, BA
,
Evan D Kharasch
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Evan D Kharasch
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Affiliations

  • the Department of Anesthesiology, University of Washington Seattle, WA. USA
  • the Puget Sound Veterans Administration Medical Center, Seattle, WA. USA

Correspondence

  • Address reprint requests to Dr Kharasch, Department of Anesthesiology, Box 356540, University of Washington, Seattle, WA 98195.
, MD, PhDcorrespondence
x
Evan D Kharasch
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Affiliations

  • the Department of Anesthesiology, University of Washington Seattle, WA. USA
  • the Puget Sound Veterans Administration Medical Center, Seattle, WA. USA

Correspondence

  • Address reprint requests to Dr Kharasch, Department of Anesthesiology, Box 356540, University of Washington, Seattle, WA 98195.
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90039-0
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Abstract

The purpose of this study was to determine if flumazenil is absorbed from broncho-pulmonary tissue after intratracheal administration and whether therapeutically significant plasma concentrations can be obtained. Six elective surgical patients received a dose of 1.0 mg flumazenil in 10 mL saline intratracheally during general anesthesia. Blood samples were drawn for 6 hours after administration and plasma concentrations were determined by gas chromatography-mass spectrometry (GC-MS). An average peak plasma flumazenil concentration of 65.9 ± 43.1 ng/mL was attained within 1 minute after administration. No patients reported chest discomfort or dyspnea upon awakening and there were no other side effects noted. Administration of flumazenil via an endotracheal tube results in rapid attainment of therapeutic blood levels.

Keywords:

Flumazenil, endotracheal, intratracheal, benzodiazepine, overdose

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☆Supported in part by a merit review award from the Veterans Affairs Research Service. Flumazenil and midazolam were donated by Roche Laboratories, Nutley, NJ.

☆Dr Palmer is currently affiliated with the Toxicology Program, College of Pharmacy, University of New Mexico, Albuquerque.

© 1998 Published by Elsevier Inc.
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March 1998Volume 16, Issue 2, Pages 170–172