Midazolam and flumazenil in ophthalmology

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Abstract
Midazolam's pharmacodynamic properties are used in ophthalmology in several indications: 1. to relieve anxiety and unwanted reactions during radial keratotomy in ambulatory patients; 2. to provide sedation and amnesia during cataract surgery using local anaesthesia, in combination with low doses of phenoperidine; 3. to induce general anaesthesia, combined with fentanyl and vecuronium, for intraocular surgery in the elderly; and 4. to decrease intraocular pressure. Flumazenil is not in routine use but is usually administered to antagonise the deleterious effects of midazolam on upper airway resistances and the respiration system and may be used to reverse "paradoxical", i.e. anxiogenic reactions to benzodiazepines in the elderly.

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