Re-audit of the use of flumazenil following midazolam-induced conscious sedation

Muhammad Syafiq Asyraf Rosli; Ellie Heidari

doi:10.1038/s41405-023-00163-7

Re-audit of the use of flumazenil following midazolam-induced conscious sedation

BDJ Open. 2023 Aug 4;9(1):36. doi: 10.1038/s41405-023-00163-7.

Authors

Muhammad Syafiq Asyraf Rosli^{1

2}, Ellie Heidari³

Affiliations

¹ Clinical Lecturer, Faculty of Dentistry, National University of Malaysia, Kuala Lumpur, Malaysia. syafiqasyraf@ukm.edu.my.
² Postgraduate Dentist, Sedation and Special Care Department, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK. syafiqasyraf@ukm.edu.my.
³ Senior Specialist Clinical Teacher, Centre for Dental Education, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.

Abstract

Introduction: Flumazenil is an antagonist drug of Benzodiazepam (BDZ) that has been used as a reversal agent of midazolam-induced conscious sedation (CS) in both emergency and elective procedures. For CS procedure, a high-quality record keeping and clinical justification prior to admission of flumazenil are recommended. Clinical Audit (CA) enables clinicians to evaluate the quality and standard of recorded clinical procedures.

Methods: This re-audit investigated the reasons for the use of flumazenil and record keeping's quality with particular emphasis on CS. In this retrospective reaudit, the authors looked at the patients' records who had received dental care under CS in the Sedation and Special Care Department of (SSCD), United Kingdom from January to June 2022.

Results: Out of 665 patients who received midazolam-induced CS, 21 patients were administered IV Flumazenil. The commonest reason (9, 42.8%) was due to prolonged recovery.

Conclusion: This re-audit highlighted the need for administrating flumazenil in certain patient groups, and/or circumstances (not emergency). The importance of maintaining high-quality record keeping is discussed.