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).
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