Review: flumazenil leads to clinical and electroencephalographic improvement in hepatic encephalopathy in patients with cirrhosis.

M a i n r e s u l t s 6 placebo-controlled studies involving 641 patients (326 assigned to flumazenil and 315 assigned to placebo) met the selection criteria. Treatment duration ranged from 5 minutes to 3 days. Combining data from 5 trials (317 patients assigned to flumazenil and 306 to placebo) showed that more patients who received flumazenil had clinical improvement than did those who received placebo (Table). Combining data from 3 trials (291 patients assigned to flumazenil and 286 to placebo) showed that more patients who received flumazenil had electroencephalographic improvement than did those who received placebo (Table). Adverse events were not reported in 4 trials. 1 trial reported adverse events in 4 patients assigned flumazenil (no mention was made of patients in the placebo group), and 1 trial showed no adverse effects in either group.