Repeated Intranasal Flumazenil Administration in Adult Subjects During Prolonged Benzodiazepine-induced Sedation

As part of a study exploring the use of oral diazepam to reduce carbon dioxide production and extend survival in a disabled submarine, intranasal flumazenil was used repeatedly over 48 hours to intermittently reverse benzodiazepine- induced sedation in six adult male subjects. Previous reports of intranasal flumazenil have been limited to pediatric pa- tients. Here we report the time course of administration of intranasal flumazenil and its effects on adult subjects, in whom flumazenil was given during sedation/reversal/re-sedation cycles. Sedation scores increased with flumazenil administra- tion in 24 of the 30 cycles, and in 100% of cases when subjects were at deeper levels of sedation.