Flumazenil, a
gamma-aminobutyric acid receptor antagonist, can promote arousal even under
general anesthesia without the use of
benzodiazepines. We hypothesized that
flumazenil could promote arousal and reduce
emergence agitation in patients undergoing
orthognathic surgery with
sevoflurane anesthesia. One hundred and two patients were randomly allocated to the control or
flumazenil group. Saline or
flumazenil was administered at the end of the surgery. The incidence of
emergence agitation was measured by using Aono's four-point scale, with scores of 3 and 4 indicating
emergence agitation. The primary outcome was the incidence of
emergence agitation. Secondary outcomes included duration of
emergence agitation and time intervals between the discontinuation of
anesthetics, first response, extubation, and post-
anesthesia care-unit discharge readiness. The incidence of
emergence agitation was 58.3% and 38.9% in the control and
flumazenil groups, respectively, but it was not statistically significant. However, the duration of
emergence agitation was shorter in the
flumazenil group (p = 0.012). There were no significant differences in the time intervals between the discontinuation of
anesthetics, first response, and extubation. Although
flumazenil did not reduce the incidence of
emergence agitation in patients undergoing
orthognathic surgery with
sevoflurane anesthesia, it can be considered as an option for awakening patients in terms of improving emergence profiles.