Flunitrazepam as an Induction Agent in Elderly, Poor‐Risk Patients

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Abstract
Great interindividual variation was found in response to flunitrazepam when the latter was used as an induction agent for general anesthesia in elderly, poor-risk patients. No significant changes in the pharmacokinetics of this nitrobenzodiazepine derivative were found, which suggests that there are pharmacodynamic alterations in response to the drug with advancing age. A sudden but transient drop in blood pressure was found in 3 of 12 patients, even though flunitrazepam was given i.v. in low, 0.3-0.5 mg incremental doses. A marked amnesic effect occurred. No analgesics were needed in the recovery room (2 h), supporting the evidence that flunitrazepam has an analgesic-sparing effect. Flunitrazepam resulted in smooth induction of anesthesia, but a long time was needed for induction.