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PubMedDate not supplied

Effects of flunitrazepam on local cerebral glucose utilization in the rat brain.

Flunitrazepam effects on local cerebral glucose utilization in the rat brain were investigated with the (14C) 2-Deoxy-D-Glucose procedure. The drug decreased glucose utilization in many areas of the rat brain, whereas no increases were observed. In this respect, the metabolic effects of flunitrazepam were different from those of other CNS "depressant" drugs, such as isoflurane and phencyclidine. Compared to the metabolic changes induced by diazepam, flunitrazepam peak effects appeared later and involved a greater number of regions.

Animals↗
PubMed1987

Temazepam versus flunitrazepam as an oral premedication in adult surgical patients.

In a randomized study, 20 patients received temazepam 20 mg orally the night before and 20 mg in the morning of an operation performed under spinal analgesia (Group I); 20 patients received flunitrazepam I mg similarly (Group 2). Different aspects of the premedication were evaluated verbally, with the aid of a visual analogue scale, Maddox wing apparatus, the critical flicker fusion threshold test, blood pressure and heart rate measurements, serum and CSF cortisol and plasma ADH measurements, as well as CSF drug level determinations. Clinically, temazepam 20 mg proved to be comparable with flunitrazepam I mg, although the latter more effectively prevented cardiovascular changes and pre-operative hormonal stress reaction. No correlation was found between the CSF drug level (bioassayed by radioreceptor assay) and the clinical response of the two benzodiazepines, nor was there any correlation between the cortisol or ADH levels versus the CSF drug levels. On the whole, flunitrazepam proved to be marginally better than temazepam as an oral premedicant.

Administration, Oral↗
PubMed1985

[Hemodynamic effects of an etomidate-flunitrazepam or midazolam- fentanyl combination for induction of anesthesia in patients with heart valve diseases].

A comparison of the haemodynamic effects of 3 anaesthetic techniques, the combinations etomidate + fentanyl (I), flunitrazepam + fentanyl (II) or midazolam + fentanyl (III), respectively was carried out in 45 patients undergoing various types of cardiac valve replacement surgery. Haemodynamics were assessed by continuously measuring the heart rate as well as the blood pressure in the systemic and pulmonary circulations whereas the cardiac output was measured intermittently. In the first 30 minutes after induction of anaesthesia, a mean arterial blood pressure drop of 10% (I), 20% (II) or 15% (III) respectively, was observed; at the same time, the rate did not change significantly. Cardiac index, however, fell significantly in all 3 groups by 33% (I) 30% (II) or 28% (III), respectively. Pulmonary pressure, wedge pressure and systemic vascular resistance rose only in groups I and III and decreased in group II (flunitrazepam + fentanyl). On the other hand, pulmonary vascular resistance as well as left ventricular work index were significantly decreased in all 3 groups. We conclude that all 3 anaesthetic techniques investigated here may be effectively applied for safe induction of anaesthesia in patients with valvular lesions of the heart. On account of the effect of the combination flunitrazepam + fentanyl on decreasing pulmonary artery pressure and wedge pressure, this technique seems to be preferable in patients with pulmonary hypertension.

Adolescent↗
PubMed1988

Reversal of flunitrazepam with flumazenil: duration of antagonist activity.

The duration of action, dose requirements and efficacy of flumazenil, a specific benzodiazepine antagonist, were evaluated in 50 patients scheduled for orthopaedic surgery under local anaesthesia and flunitrazepam sedation. Fifteen minutes after injection of flunitrazepam 0.03 mg kg-1 the patients received placebo or flumazenil i.v. in a randomized, double-blind and titrated fashion. At selected time intervals, sedation, anterograde amnesia, muscular hypotonia, orientation in time and space, comprehension and collaboration were evaluated. Compared with placebo, flumazenil promptly reversed sedation for 30 min, hypotonia for 45 min and anterograde amnesia for 60 min, and improved orientation and collaboration for 60 min. However, after 90 min significant recurrent sedation was observed, while anterograde amnesia reappeared after 60 and up to 120 min. No side-effects were noted at any time. The dose of flumazenil required for reversal of flunitrazepam sedation was 0.35 +/- 0.15 mg (mean +/- SD).

Adult↗
PubMed1987

[Metoclopramide, methylprednisolone and flunitrazepam in cytostatic-induced vomiting].

The antiemetic efficacy of a combination of high-dose metoclopramide, methylprednisolone and flunitrazepam was tested in an open pilot study in 30 tumor patients undergoing strongly emetic chemotherapy. 26 of 30 patients (87%) were partially or completely protected from nausea and vomiting. In 11 of 12 patients receiving the strongly emetogenic cytostatic agent cisplatin in a dose of greater than or equal to 50 mg/m2, the gastrointestinal side effects were partially or completely abolished. The antiemetic efficacy of the combination was maintained during subsequent courses of chemotherapy. All patients experienced somnolence after administration of flunitrazepam. Only 2 of 30 patients had a shortlived extrapyramidal reaction. The combination of high-dose metoclopramide, methylprednisolone and flunitrazepam is an effective antiemetic treatment and should be considered as first-line antiemetic treatment in patients receiving strongly emetic cancer chemotherapy.

Adolescent↗
PubMed1987

Aminophylline reversal of flunitrazepam sedation.

Seventeen otherwise healthy patients were given either intravenous physiologic saline, 5 ml, or aminophylline, 2 mg/kg, randomly 30 min after they were given intravenous flunitrazepam in doses adequate to produce sleep and sedation during spinal anesthesia for anorectal surgery. In the control group, mean sedation scores were 1.8 +/- 0.3 and 1.0 +/- 0.4 15 and 45 min after injection of placebo. Fifteen and 45 min after the injection of aminophylline the mean scores of sedation were 0.4 +/- 0.2 and 0.2 +/- 0.2, respectively. Even though the patients in both groups appeared to be equally alert and responsive after 75 min, Trieger tests revealed that psychomotor function was still significantly impaired in the control group 90 min after the injection of placebo. The amnesic effects of flunitrazepam were not affected by aminophylline. Aminophylline may be used to reverse the sedative and psychomotor effects of flunitrazepam.

Adult↗
PubMedDate not supplied

[Hemodynamic effects of flunitrazepam in coronary patients. Postoperative study immediately after digestive tract and orthopedic surgery].

The present study was designed to evaluate the haemodynamic effects of flunitrazepam used for sedation in the post operative period after abdominal or orthopedic surgery. Patients with coronary artery disease (C.A.D.) were divided in two groups; in group II stable cardiac failure was present. Results did not show any significant haemodynamic changes after flunitrazepam in both groups. Flunitrazepam is a haemodynamic secure and valuable agent for sedation during recovery for patients with C.A.D. even in stable cardiac failure.

Blood Gas Analysis↗
PubMed1985

Flunitrazepam prevents succinylcholine-induced increase in intra-ocular pressure.

Ninety-three patients scheduled for various elective surgical procedures were divided into three equal groups and had induction of anaesthesia with either thiopentone (5 mg/kg), thiopentone (5 mg/kg) plus gallamine (0.3 mg/kg), or with flunitrazepam (0.03 mg/kg). Four minutes after induction they received a bolus intravenous injection of succinylcholine (1 mg/kg). Intra-ocular pressure was measured before and after induction, and approximately 1 minute after succinylcholine. It was found that flunitrazepam prevented the increase in intra-ocular pressure better than thiopentone plus gallamine. In both these groups, the subsequent intravenous administration of succinylcholine slightly increased the pressure but to levels below that noted before anaesthesia was induced. However, intra-ocular pressure was significantly increased above baseline levels when succinylcholine was injected after induction with thiopentone alone. Flunitrazepam is recommended, therefore, as a possible alternative for thiopentone-gallamine induction with succinylcholine when an increase in intra-ocular pressure must be prevented.

Adolescent↗
PubMed1975

[The effects of flunitrazepam (rohypnol) on respiration (author's transl)].

The effects of flunitrazepam (0.03 mg/kg administered intravenously over a two-minute period) was investigated in 11 healthy volunteers with normal pulmonary function. Spirometer tracings were recorded continuously by the Siregnost FD 40 and blood gas measurements were performed by the Harnoncourt AVL gas analyzer. Flunitrazepam produced a characteristic cyclical hypoventilation/hyperventilation pattern lasting 15 min., followed by quiet sleeping rhythms. The duration of action was 20 min. There was a significant fall in PCO2, whilst the CO2 tension showed a significant rise. Changes in pH were in accordance with respiratory acidosis. Apnoea did not occur after the administration of flunitrazepam.

Anti-Anxiety Agents↗
PubMed1980

[Slow cerebral potentials after administration of flunitrazepam to subjects with sleep disorders].

12 patients admitted for neurological diseases and suffering from sleep disturbances, were given Flunitrazepam and placebo (double blind test) in a single evening dose of 1 and 2 mg. Morning recordings of the expectation wave according to G. Walter's technique did not reveal significant changes in wave morphology, amplitude and latency. The psychophysical conditions of patients and their reaction times did not differ after Flunitrazepam and placebo. The research shows, on the one hand the value of the electrophysiological investigation method and, on the other, the absence of residual effects in the morning after Flunitrazepam administration.

Adult↗
PubMed1980

[The effects of thiopentone, etomidate and flunitrazepam on cerebral energy metabolism in the rat (author's transl)].

The effect of thiopentone, etomidate and flunitrazepam on cerebral energy metabolism was investigated in the male Wistar rat. Brain cortex was deep-frozen in situ under steady state conditions (normotension, normothermia, normoxia and normocapnia) of a standardized anaesthesia. Anaesthesia with thiopentone led to an decrease in glycolytic flux on the level of the hexokinase and/or phosphofructokinase reaction as well as reduced citric acid cycle intermediates. The brain cortex levels of high-energy phosphates however are unchanged thus indicating an adequate supply of energy for the brain. Similar results were obtained when anaesthesia was induced with etomidate and flunitrazepam. In spite of the fact that flunitrazepam seemed not to influence the phosphofructokinase reaction an equivalent hypnotic dose of each drug led to comparable metabolic effects in the brain cortex.

Anesthesia, Inhalation↗
PubMed1980

Flunitrazepam for the intravenous induction of anaesthesia in children.

Flunitrazepam (Rohypnol) was compared with thiopentone as an anaesthetic induction agent in children between 4 and 12 years of age who underwent elective minor surgical procedures. Successful induction of anaesthesia was achieved in both groups of patients. With flunitrazepam the induction time was longer but not statistically different from that with thiopentone. The incidence of apnoea was higher with thiopentone, but not significantly so. It is concluded that flunitrazepam could prove a reasonable alternative to thiopentone as an intravenous induction agent in children who have to undergo elective minor operations.

Anesthesia, Intravenous↗
PubMed1980

[The influence of flunitrazepam on the blood gases during subarachnoid block in geriatric patients (author's transl)].

Fifty-three geriatric patients under subarachnoid block for orthopaedic surgery received flunitrazepam 0.3-0.4 mg intravenously. Blood gases were checked while breathing room air. This dose caused a significant but small respiratory depression (p less than 0.05). These results confirm other reports on flunitrazepam, but used without spinal anaesthesia. There was no case, however, who needed ventilatory support. Top up doses up to a total of 1 mg caused no further significant changes. We feel that Flunitrazepam is a useful drug for sedation during regional block including poor risk patients.

Aged↗
PubMed1981

[The use of flunitrazepam in ICU patients (author's transl)].

Flunitrazepam exhibits principally the same effects as other benzodiazepines, i.e. sedation, sleep induction, amnesia and muscle relaxation. These effects are maintained for several hours and are additive to those of other drugs, e.g. narcotic analgesics. When flunitrazepam is used in ICU patients its long duration of action and depressant influence on the respiration have to be taken into account. Therefore it is preferred in cases with severe cerebral trauma, prolonged sepsis, or tetanus requiring long-term respiratory treatment. The mean single dose is 1.0 mg and the interval between consecutive doses is, on average, 2 to 3 hours. After prolonged use of flunitrazepam, at least 24 to 48 hours are necessary for sedation and muscle relaxation to disappear to such an extent that transition from mechanical to spontaneous ventilation is possible. Severe side-effects, e.g. cardiac arrhythmias, metabolic disturbances, impairment of renal function, changes in electrolyte or acid-base balance, have not been observed. Peripheral vasodilation is common and may lead to a decrease in arterial blood pressure.

Animals↗
PubMed1981

A comparative study on the clinical effects of flunitrazepam and oxazepam as oral premedication.

The clinical effects of flunitrazepam and oxazepam as oral premedicants were tested in a double-blind study of 69 otorhinolaryngologic patients. Flunitrazepam had a somewhat higher sedative effect (p less than 0.10) and moderated the increase in systolic blood pressure significantly (p less than 0.005) more than did oxazepam, but as regards the other parameters tested no significant differences were found (sleep, apprehension, excitement, dizziness, emetic effect, headache, increase in heart rate, venepuncture). In some patients a profuse salivary secretion was observed despite intravenous injection of atropine just before the induction of anesthesia. Our results support earlier claims of flunitrazepam's relatively strong sedative and anxiolytic properties, but on the whole the difference in clinical effects of these benzodiazepine derivatives was not marked.

Administration, Oral↗
PubMed1982

Intravenous flunitrazepam in the prevention of the side effects of succinylcholine.

Muscular fasciculations, plasma potassium levels and postoperative muscle pains following succinylcholine injection were studied in 64 patients who had been given either dilute flunitrazepam or sodium thiopental to induce anesthesia. In the 32 patients with flunitrazepam-induced anesthesia, muscle fasciculations were present in only 8 and postoperative muscle pains in 4, while none of the patients had elevated plasma potassium. In the thiopental group, muscle fasciculations and postoperative muscle pains were present in 28 and 22 of the other 32 patients, respectively, while all had significantly elevated plasma potassium levels. Flunitrazepam appears to be a useful alternative anesthesia-induction agent that prevents some of the side effects of succinylcholine without reducing its efficiency.

Adolescent↗
PubMed1980

[Medication with flunitrazepam in electroconvulsive therapy].

The electroconvulsive therapy (ECT) continues to be of use in the management of patients suffering from affective psychosis and some clinical forms of schizophrenia. The use of premedicated anaesthetic and miorelaxant drugs lessens the possibility of complications, but risks the induction of serious cardiorespiratory accidents. The flunitrazepam is a benzodiazepine with hypnotic, ansiolytic and miorelaxant properties, which has been used as an anaesthetic in major and minor surgery. 241 ECT were essayed on 28 psychotic patients and flunitrazepam induced deep sleep in 94.6% of the applications within 0.5 and 15 minutes after the intravenous injection, the required dose oscillating between 2 and 4 mg. In all the applications a generalized convulsive crisis was induced. No significant pulse variations, arterial pressure, nor respiratory frequency took place. Post ECT agitation appeared in 0.82%. The associated pharmacological therapy (neuroleptics, lithium salts) did not modify the effect of flunitrazepam. Nor did tolerancy to the drug appear.

Adolescent↗