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Evidence summaries

Flumazenil for Hepatic Encephalopathy

Flumazenil is effective for short-term improvement of hepatic encephalopathy in patients with cirrhosis, but there is no effect on survival. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 14 randomised clinical trials with 867 participants, the majority of whom had an acute episode of overt hepatic encephalopathy.

In total, 32/433 (7.4%) participants allocated to flumazenil versus 38/409 (9.3%) participants allocated to placebo died (RR 0.75, 95% CI 0.48 to 1.16; 11 trials). No beneficial or harmful effects of flumazenil were found on all-cause mortality. Flumazenil was associated with a beneficial effect on hepatic encephalopathy (RR 0.75, 95% CI 0.71 to 0.80; 824 participants; nine trials).

    References

    • Goh ET, Andersen ML, Morgan MY et al. Flumazenil versus placebo or no intervention for people with cirrhosis and hepatic encephalopathy. Cochrane Database Syst Rev 2017;(8):CD002798. [PubMed]

Primary/Secondary Keywords