A comparison of 3 routes of flumazenil administration to reverse benzodiazepine-induced desaturation in an animal model

John H. Unkel, Tegwyn H. Brickhouse, Trevor W. Sweatman, Mark Scarbecz, William P. Tompkins, Chad S. Eslinger

Research output: Contribution to journalArticle

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Abstract

Purpose: The purpose of this study was to examine intralingual (IL) and submucosal (SM) delivery of flumazenil as viable alternatives to immediate intravenous (IV) administration for reversing benzodiazepine sedation in an animal model. Methods: A dog animal model was chosen based upon comparable body weight to children (12-17 kg) and the ease of oral access in this species. Research design was a nonrandomized matched pair study. This type of "before-and-after study" allowed the dogs to receive 3 different routes of flumazenil administration (IV, IL, and SM) following an initial dose of midazolam (0.5 mg/kg IV). Blood samples were obtained (at 0, 2, 4, 8, 15, and 30 minutes) for high performance liquid chromatography (HPLC) analysis of flumazenil and midazolam, and oxygen saturation values were recorded. Results: Both IL and SM delivery of flumazenil were determined to be viable alternatives to immediate IV administration for reversing benzodiazepine-induced oxygen saturation (SaO2) desaturation. For flumazenil to be able to reverse the SaO2 desaturation, the plasma levels must be greater than 5 ng/ml, which was exceeded by IL and SM drug delivery. Conclusion: In a benzodiazepine-induced desaturation, the submucosal and intralingual routes are viable alternatives to intravenous administration of flumazenil in an animal model.

Original languageEnglish (US)
Pages (from-to)357-362
Number of pages6
JournalPediatric dentistry
Volume28
Issue number4
StatePublished - Dec 1 2006

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Flumazenil
Benzodiazepines
Animal Models
Intravenous Administration
Midazolam
Dogs
Oxygen
Research Design
High Pressure Liquid Chromatography
Body Weight
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Dentistry(all)

Cite this

Unkel, J. H., Brickhouse, T. H., Sweatman, T. W., Scarbecz, M., Tompkins, W. P., & Eslinger, C. S. (2006). A comparison of 3 routes of flumazenil administration to reverse benzodiazepine-induced desaturation in an animal model. Pediatric dentistry, 28(4), 357-362.

A comparison of 3 routes of flumazenil administration to reverse benzodiazepine-induced desaturation in an animal model. / Unkel, John H.; Brickhouse, Tegwyn H.; Sweatman, Trevor W.; Scarbecz, Mark; Tompkins, William P.; Eslinger, Chad S.

In: Pediatric dentistry, Vol. 28, No. 4, 01.12.2006, p. 357-362.

Research output: Contribution to journalArticle

Unkel, JH, Brickhouse, TH, Sweatman, TW, Scarbecz, M, Tompkins, WP & Eslinger, CS 2006, 'A comparison of 3 routes of flumazenil administration to reverse benzodiazepine-induced desaturation in an animal model', Pediatric dentistry, vol. 28, no. 4, pp. 357-362.
Unkel, John H. ; Brickhouse, Tegwyn H. ; Sweatman, Trevor W. ; Scarbecz, Mark ; Tompkins, William P. ; Eslinger, Chad S. / A comparison of 3 routes of flumazenil administration to reverse benzodiazepine-induced desaturation in an animal model. In: Pediatric dentistry. 2006 ; Vol. 28, No. 4. pp. 357-362.
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