Effect of flumazenil on recovery of memory following recovery of consciousness from general anesthesia with remimazolam: a randomized, open-label, single-center controlled trial.

IF 1.2 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-10-21 DOI:10.1186/s40981-025-00825-5

Keiko Nobukuni, Kazuhiro Shirozu, Masako Asada, Taichi Ando, Etsuko Kanna, Kotaro Kakehashi, Ryotaro Shiraki, Makoto Kubo, Ken Yamaura

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Abstract

Background: Recovery of consciousness from general anesthesia with remimazolam, an ultrashort-acting benzodiazepine, occurs rapidly. However, patients after recovery of consciousness from general anesthesia with remimazolam often experience periods of amnesia. Remimazolam can be antagonized by flumazenil. Therefore, we investigated the effect of flumazenil on the recovery of memory following the recovery of consciousness from general anesthesia with remimazolam.

Methods: This single-center randomized controlled trial was conducted from November 2023 to July 2024. Forty-four patients undergoing breast surgery were enrolled. The patients received general anesthesia with remimazolam and remifentanil and were randomized to receive flumazenil after recovery of consciousness or not. The recovery of the memory was evaluated by showing an A4-size poster (illustration) to the patients and asking them to remember the poster every 1 h. Furthermore, the effect-site concentration of remimazolam was calculated using the Masui model.

Results: All 44 patients (22 with and 22 without flumazenil) were assessed. The percentage of patients who remembered the poster 1 h after regaining consciousness was significantly higher in the flumazenil group than in the no flumazenil group (95.5 vs 40.9%; p < 0.001). All patients could recall the poster within 2 h postoperatively. The mean effect-site concentration of remimazolam at the time of consciousness recovery was similar between the two groups (0.31 ± 0.08 µg/mL).

Conclusions: Flumazenil significantly accelerated the recovery of memory retention in patients who had recovered consciousness from general anesthesia with remimazolam. However, even without the administration of flumazenil, all patients successfully recovered their memory within 2 h after regaining consciousness.

Trial registration: This clinical trial was registered at the University Hospital Medical Information Network (UMIN) Center on November 01, 2023 (UMIN-CTR: UMIN000052659).

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氟马西尼对全身麻醉雷马唑仑恢复意识后记忆恢复的影响：一项随机、开放标签、单中心对照试验

背景：雷马唑仑是一种超短效苯二氮卓类药物，全身麻醉后意识恢复迅速。然而，病人在全身麻醉后使用雷马唑仑恢复意识后，经常会出现失忆期。氟马西尼可拮抗雷马唑仑。因此，我们研究氟马西尼对全身麻醉雷马唑仑恢复意识后记忆恢复的影响。方法：于2023年11月至2024年7月进行单中心随机对照试验。44名接受乳房手术的患者被纳入研究。患者接受雷马唑仑和瑞芬太尼全麻，意识恢复后随机给予氟马西尼。通过向患者展示a4大小的海报（插图），并要求他们每1小时记住海报，评估记忆的恢复情况。此外，使用Masui模型计算雷马唑仑的效应位点浓度。结果：44例患者（22例使用氟马西尼，22例未使用氟马西尼）均被评估。氟马西尼组患者恢复意识后1 h记得海报的比例明显高于未加氟马西尼组（95.5% vs 40.9%）； p结论：氟马西尼显著加速了全麻雷马唑仑恢复意识患者记忆保留的恢复。然而，即使没有给予氟马西尼，所有患者在恢复意识后2小时内都成功恢复了记忆。试验注册：本临床试验于2023年11月1日在大学医院医疗信息网络（UMIN）中心注册（UMIN- ctr: UMIN000052659）。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.