Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THIAMYLAL”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1997

[Analysis of mild barbiturate-moderate hypothermia therapy on the authors' 152 cases].

Mild barbiturate-moderate hypothermia therapy was established for severe head injury and cerebrovascular disease. This study was conducted on 152 patients from April 1984 through July 1995. In this study were included patients with Glagow Coma Scale score of less than 8 points but those with serious systemic complications and elderly and infantile patients were excluded. Our protocol consisted of administration of thiamylal Na 1.25-2.5 mg/kg/h and droperidol 20-40 micrograms/kg/h (mild barbiturate) while maintaining a core temperature of 32-34 degrees C (moderate hypothermia). The clinical outcome was good (GR, MD) in 58 cases, poor (SD) in 24 cases and bad (PVS, D) in 70 cases. This therapy was found to be particularly effective for preventing ischemic neurological damage in the vasospasm stage following SAH and severe head injury in young patients. However, this therapy did not prevent pneumonia, cardiac failure, arrhythmia and hypopotassemia from occurring frequently. We conclude that this therapy is contraindicated in the elderly, i.e., those older than 65 years.

Adolescent↗
PubMed1977

Thiobarbiturate-induced dysrhythmias: the role of heart rate and autonomic imbalance.

Constantly coupled ventricular bigeminy in dogs can be elicited by intravenous boluses of thiamylal sodium. Properties of the bigeminal rhythm are similar to those produced by halothane or cyclopropane inhalation anesthetic-epinephrine-induced dysrhythmias. The mechanism responsible for the initiation of ventricular bigeminy, and perhaps most dysrhythmias in the dog during thiobarbiturate anesthesia, appears to be an imbalance between parasympathetic and sympathetic efferent activity. Moderate increases in arterial blood pressure and atrial rate augment the tendency for dysrhythmia production. Atropine was effective in abolishing ventricular bigeminy in most cases through overdrive suppression. Propranolol appeared to abolish ventricular bigeminal rhythms by suppression of sympathetic efferent activity without causing noticeable changes in arterial blood pressure.

Animals↗
PubMed1998

[A comparison of the incidence of postoperative nausea and vomiting after propofol-fentanyl anesthesia and that after nitrous oxide-isoflurane anesthesia].

We compared the incidence of postoperative nausea and vomiting after total intravenous propofol-fentanyl anesthesia (TIVA group) and that after thiamylal-nitrous oxide-isoflurane anesthesia (GOI group) in 60 ASA physical I and II patients for elective abdominal simple total hysterectomy. When the patients returned to the ward, the incidence of nausea was lower in TIVA group than in GOI group (P < 0.05), but no difference was found in the incidence of vomiting between the two groups. There were no differences in the incidence of nausea and vomiting 6 hours after the operation and on the next morning between the two groups. Postoperative pain scores were similar between the two groups, while total postoperative evaluation scores (nausea, vomiting, pain, fever, and sleep disturbance) were lower in TIVA group (P < 0.05). We conclude that TIVA with propofol-fentanyl reduced the incidence of nausea and improved total evaluation scores in the immediate postoperative period.

Adult↗
PubMed1998

[Two cases of clipping surgery of cerebral aneurysm under profound hypothermia with closed-chest extracorporeal circulation].

A 68-year-old female and a 47-year-old male patients underwent clipping surgery for giant basilar arterial and thrombotic internal carotid arterial aneurysms respectively with closed-chest extracorporeal circulation (femoro-femoral bypass). Profound hypothermia and continuous infusion of thiamylal were used to prevent brain damage. Blood outflow via the femoral vein was sufficient to induce profound hypothermia down to 20 degrees C. Hemodynamics were controllable without catecholamines during closed-chest extracorporeal circulation. Preoperative symptoms significantly improved and no neurological complication was observed in either case postoperatively. Right femoral phlebothrombosis was, however, observed in one case. In conclusion, profound hypothermia with closed-chest extracorporeal circulation is a safe technique to reduce the complications induced by open-chest technique, but special attention should be given to postoperative phlebothrombosis.

Aged↗
PubMed1998

[Anesthetic management of a patient with the allergic granulomatous angitis (Churg-Strauss syndrome)].

We gave anesthesia 4 times to a patient (19-year-old female) with allergic granulomatous angitis (AGA). She had asthma, myopathy and detrimental side effect in her eyes of steroid therapy for AGA. Two of the 4 operations were emergency laparotomy for peritonitis due to colon perforation, and the other 2 operations were elective eye surgeries. General anesthesia was induced with thiamylal (1st operation) or midazolam (2nd-4th operation). Intraoperative anesthesia was maintained with N2O-O2-isoflurane combined with thoracic epidural anesthesia (1st operation) or N2O-O2-sevoflurane (2nd-4th operation). Asthmatic attack, which AGA accompanies frequently, did not occur during these anesthetic managements. The steroid therapy, which is a fundamental means to control the allergic syndrome, might suppress asthma. However, asthmatic attack and systemic vasculitis should be kept in mind in anesthetic management of AGA.

Adolescent↗
PubMed1998

Barbiturates impair astrocyte glutamate uptake.

Barbiturates are widely used as neuroprotective agents during status epilepticus and during surgical procedures that cause cerebral ischemia. The efficacy of this practice is unproved, however, and while barbiturates may counter neuronal excitotoxicity, they can also inhibit mitochondrial ATP production. Since glutamate uptake is energetically costly, mitochondrial inhibition could impair glutamate uptake. To examine this possibility, glutamate uptake was measured in primary rat astrocyte cultures in the presence of several barbiturates. Different barbiturates had differing effects on glutamate uptake at normal glucose concentrations, but all potentiated inhibition of glutamate uptake during glucose deprivation. Thiamylal and thiopental were the most potent barbiturates examined, with 0.3 mM causing approximately 40% reduction in glutamate uptake rates. Barbiturates also potentiated ATP depletion during glucose deprivation, supporting mitochondrial inhibition as the mechanism of these effects. These findings suggest that barbiturates can, under some conditions, impair glutamate uptake at concentrations relevant to their clinical use.

Adenosine Triphosphate↗
PubMed1990

Sensitivity to vecuronium in myasthenia gravis: a dose-response study.

A cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle were used to determine the potency of vecuronium in 20 normal patients and in ten patients with myasthenia gravis under thiamylal, N2O, O2, fentanyl anaesthesia. The mean (+/- SEM) values for ED50, ED90, and ED95 in the normal patients were 19 +/- 1, 31 +/- 1 and 36 +/- 2 micrograms.kg-1, respectively. Myasthenic patients showed increased sensitivity to vecuronium, the mean values for ED50, ED90, and ED95 were 10 +/- 2, 17 +/- 2 and 20 +/- 3 micrograms.kg-1, being 50, 55 and 56 per cent of normal, respectively. We did not demonstrate a difference in sensitivity to vecuronium between those myasthenic patients who received pyridostigmine preoperatively and those who did not, nor among those chronically treated with corticosteroids, compared with those who were not.

Adult↗
PubMed1990

A defasciculating dose of d-tubocurarine causes resistance to succinylcholine.

Forty-four patients, ASA physical status I or II, undergoing thiamylal, fentanyl, N2O/O2 anaesthesia were studied to determine the dose-response to succinylcholine (Sch) without prior defasciculation (24 pt - Group 1), or three minutes following d-tubocurarine (dTC), 0.043 mg.kg-1 (20 pt - Group 2). The individual log dose-logit response curve for each patient was determined using a cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle. The mean (+/- SEM) ED50, ED90 and ED95 values for Sch in Group 1 were 0.13 +/- 0.01, 0.19 +/- 0.01 and 0.22 +- 0.01 mg.kg-1, and in Group 2 were 0.16 +/- 0.01, 0.25 +/- 0.01 and 0.29 +/- 0.02 mg.kg-1, respectively. The mean ED values in Group 2 were significantly greater than the equivalent values in Group 1 (P less than 0.05). Compared with values in Group 1, ED values in Group 2 represented mean increases of 23, 32, and 32 per cent, respectively. These pharmacodynamic data indicate that the dose of Sch needs to be increased by 32 per cent following a defasciculating dose of dTC 3 mg.70 kg-1 (0.043 mg.kg-1).

Adult↗
PubMed1995

Attenuation of the catecholamine response to tracheal intubation with oral clonidine in children.

We conducted a prospective, randomized, double-blind , controlled clinical trial to examine (1) whether plasma catecholamine (CA) concentrations increased in response to tracheal intubation in children, and (2) the effects of clonidine on the CA responses. Sixty children (ASA physical status I) aged 7-13 yr were allocated to one of three groups (n = 20 for each group): diazepam 0.4 x kg(-1) (active control), clonidine 2 micrograms x kg(-1), or clonidine 4 micrograms x kg(-1) po. These agents were administered 105 min before induction of anaesthesia followed by oral atropine 0.03 mg x kg(-1) given 60 min before anaesthesia which was induced with thiamylal 5 mg x kg(-1) and tracheal intubation was facilitated with vecuronium 0.2 mg x kg(-1). Laryngoscopy, lasting 30 sec, was attempted two minutes after administration of the induction agents. Serial values for blood pressure, heart rate, and venous plasma CA concentrations were compared among the three groups and with the respective preinduction measurements. Children receiving diazepam or clonidine 2 micrograms x kg(-1) showed remarkable increases in systolic and diastolic blood pressures, heart rate, and plasma CA concentrations in response to tracheal intubation (P < 0.05). The increases were similar for the two regimens. These haemodynamic and CA changes were smaller in children receiving clonidine 4 micrograms x kg(-1) (P < 0.005). The haemodynamic responses were positively correlated with the CA responses. These findings indicate that tracheal intubation following rapid sequence induction of anaesthesia in children provokes a reflex increase in sympathetic activity characterized by increased plasma CA concentrations, and that attenuation of the cardiovascular changes with a high oral dose of clonidine may be due to suppression of the increase in sympathetic activity evoked by the intubation.

Adolescent↗
PubMed2001

Values of the bispectral index do not parallel the hemodynamic response to the rapid increase in isoflurane concentration.

PURPOSE: To investigate the changes in hemodynamic variables and bispectral index (BIS) in response to a rapid increase in isoflurane or sevoflurane concentration. METHOD: Thirty adult patients were anesthetized with either isoflurane (isoflurane group) or sevoflurane (sevoflurane group). Two minutes after induction of anesthesia with thiamylal, the inspired concentrations of isoflurane and sevoflurane were rapidly increased from 0.5 minimum alveolar anaesthetic concentration (MAC) to 3 MAC and maintained for five minutes. Heart rate (HR), mean arterial pressure (MAP), and BIS were measured every minute. RESULTS: An increase in the anesthetic concentration caused increases in HR and MAP in the isoflurane group and a decrease in MAP in the sevoflurane group. Consequently, HR and MAP in the isoflurane group were significantly higher than those in the sevoflurane group. After inhalation of high concentrations, BIS significantly and progressively decreased in both groups. CONCLUSION: BIS values decrease after a step increase in volatile agent concentration, whether or not a hyperdynamic action occurs.

Adult↗
PubMed2001

Tracheal lidocaine attenuates the cardiovascular response to endotracheal intubation.

PURPOSE: In order to examine the efficacy of tracheal lidocaine (TL) for attenuation of the cardiovascular responses to endotracheal intubation (EI), we compared the cardiovascular responses to TL alone and EI with TL, with those to EI without TL. METHODS: Seventy-five patients (ASA I-II) were studied. Anesthesia was induced with fentanyl 2 microg x kg(-1) iv, thiamylal 5 mg x kg(-1) iv and sevoflurane 1.0% in oxygen. Vecuronium 0.12 mg x kg(-1) was used to facilitate EI. In Group A (n=25), three minutes after induction, EI was performed. In Group B (n=25), three minutes after induction, the patients received TL (4% lidocaine, 4 mL). This was followed by immediate EI. In Group C (n=25), EI was performed two minutes after TL. Heart rate, arterial blood pressure and rate- pressure product (RPP) were measured from one minute before induction until five minutes after EI. RESULTS: The changes of RPP caused by TL alone in Group C (TL; +34.6 +/- 29.0%, mean +/- SD) were significantly (P <0.01) less than those caused by EI without TL in Group A (+77.3 +/- 42.6%). EI after TL in Group C did not cause significant changes in RPP (+5.4 +/- 15.2%). There were no significant differences between Groups A and B (+58.3 +/- 36.6%). CONCLUSION: We conclude that the cardiovascular responses to TL alone are half as great as those to EI without TL, and that TL is effective for attenuation of the cardiovascular responses to EI. EI should be performed more than two minutes after TL.

Adult↗
PubMed2003

The ED(95) of end-tidal sevoflurane concentration for the smooth exchange of the tracheal tube for a laryngeal mask airway is 2.97%.

PURPOSE: Exchanging the tracheal tube for the laryngeal mask airway (the TT/LMA exchange) while the patient is still anesthetized avoids coughing associated with tracheal extubation. This study was conducted to determine the end-tidal concentration of sevoflurane that prevented response to this exchange in 50% patients (MAC(TT/LMA)). METHODS: We studied 21 adult male patients, ASA I, aged 21-54 yr. Anesthesia was induced with thiamylal and sevoflurane, and the trachea was intubated following vecuronium neuromuscular blockade. Anesthesia was maintained with sevoflurane and nitrous oxide in oxygen. After surgery, a predetermined end-tidal sevoflurane concentration was achieved and a steady state was maintained for at least 20 min. The concentration at which the TT/LMA exchange was attempted was determined by a modification of Dixon's up-and-down method with 0.25% as the step size. At the time of the TT/LMA exchange, no residual nitrous oxide > 3% was detected, and the return to normal neuromuscular function was confirmed. When the TT/LMA exchange was accomplished without coughing, movement, or airway obstruction, it was considered a smooth exchange. RESULTS: Sevoflurane MAC(TT/LMA) determined using the up-and-down method was 2.63% +/- 0.14%. The 50% effective dose obtained using a probit analysis was similar [2.53% (95% confidence limits, 2.13-2.82%)]. CONCLUSION: Sevoflurane MAC(TT/LMA) in adult male patients was 2.63% (1.54 MAC) and may be useful for the smooth exchange of the tracheal tube for the LMA in a clinical setting.

Adult↗
PubMed2002

The bispectral index response to tracheal intubation is similar in normotensive and hypertensive patients.

PURPOSE: To compare the hemodynamic and bispectral index (BIS) responses to tracheal intubation in normotensive and hypertensive patients. METHOD: Three minutes after induction of anesthesia with thiamylal and fentanyl, tracheal intubation was performed in 24 normotensive and 22 hypertensive patients. Heart rate (HR), mean arterial pressure (MAP), and BIS were measured every minute. RESULTS: Tracheal intubation increased HR, MAP, and BIS in both normotensive and hypertensive patients. The increase in MAP was significantly greater in hypertensive patients than in normotensive patients, but there were no differences in HR or BIS in the two groups of patients. CONCLUSION: Patients with and without hypertension exhibit the same arousal response (as measured by BIS) to tracheal intubation despite the enhanced vasopressor response in hypertensive patients.

Adult↗
PubMed2001

Cesarean section in a patient with syringomyelia.

PURPOSE: To describe the anesthetic management of Cesarean section in a patient with syringomyelia. CLINICAL FEATURES: A 27-yr-old pregnant woman with syringomyelia was scheduled to undergo elective Cesarean section. At the age of 25 yr, she had begun to experience headaches, and at the age of 26 yr, a diagnosis of syringomyelia of the upper spinal cord was made on the basis of magnetic resonance imaging findings. No symptoms other than headache were noted preoperatively. General anesthesia was used for the Cesarean section. After the administration of 1 mg vecuronium as a priming dose, 5 mg vecuronium were injected. At the onset of clinical muscle weakness, 225 mg thiamylal were promptly administered as the induction agent and the patient was intubated (timing principle with priming method) and pressure on the cricoid cartilage applied to prevent regurgitation of stomach contents. Anesthesia was maintained with oxygen, nitrous oxide and isoflurane at a low concentration. Mild hyperventilation was used throughout the procedure. Anesthesia and surgery proceeded without any problem, response to vecuronium was clinically normal and recovery was uneventful. Neurological status remained normal. CONCLUSION: We report the safe use of general anesthesia for Cesarean section in a patient with syringomyelia. Precautions were taken to avoid increases in intracranial pressure and our patient experienced no untoward neurologic event.

Adult↗
PubMed1997

Efficacy of an ultrashort-acting beta-adrenoceptor blocker (ONO-1101) in attenuating cardiovascular responses to endotracheal intubation.

OBJECTIVE: To investigate the clinical effectiveness and safety of ONO-1101, a new ultrashort-acting (half-life 3-4 min), cardioselective beta-adrenoceptor blocker in attenuating the cardiovascular responses to endotracheal intubation in a dose-finding open study. METHODS: Laryngoscopy and tracheal intubation were performed after induction of anaesthesia with thiamylal, followed by administration of succinylcholine, and saline or ONO-1101 0.1, 0.25 or 0.5 mg.kg-1, in 53 patients. Heart rate and blood pressure were continuously recorded beginning prior to administration until 5 min after administration of the drug, and the rate-pressure product was calculated. RESULTS: ONO-1101 was found to significantly blunt the increase in heart rate throughout the study. Administration of ONO-1101 0.25 or 0.5 mg.kg-1 decreased the incidence of tachycardia. However, these doses were not sufficient to suppress the increase in systolic blood pressure, although the maximal value in the ONO-1101 0.5 mg.kg-1 group was reduced. Rate-pressure product increased significantly after intubation in all groups, but the increase was suppressed in the ONO-1101 0.25 and 0.5 mg.kg-1 groups as compared with the saline group. Bradycardia was not observed in any patient, although hypotension might be caused by administration of ONO-1101 0.5 mg.kg-1. CONCLUSION: ONO-1101, especially at a dose of 0.25 mg.kg-1, due to its beta-adrenoceptor blockade and ultrashort action, was shown to be effective and well tolerated by patients in this study, when used to attenuate the cardiovascular responses to laryngoscopy and endotracheal intubation.

Adrenergic beta-Antagonists↗
PubMed1999

Improved oxygen delivery to the fetus during cesarean section under sevoflurane anesthesia with 100% oxygen.

PURPOSE: To assess the potential benefits of sevoflurane with 100% oxygen in cesarean section in terms of oxygen delivery to the fetus, neonatal depression, and uterine contractility. METHODS: Thirty-six patients undergoing elective cesarean section were enrolled. After thiamylal induction, 0.7% sevoflurane-60% nitrous oxide-40% oxygen anesthesia was administered in group G1 (n = 9), and 1.7% sevoflurane-100% oxygen anesthesia was administered in group G2 (n = 9). Spinal anesthesia under oxygen nasal prong was used in group SP (n = 18). RESULTS: At delivery, the PO(2) values in the maternal artery and the umbilical vein and artery (MA, UV, UA) of group G2 (474 +/- 50, 43 +/- 9, 32 +/- 9 mmHg, respectively) were significantly greater than those in groups G1 (228 +/- 46, 31 +/- 4, 23 +/- 5 mmHg, respectively) and SP (147 +/- 21, 30 +/- 7, 18 +/- 7 mmHg, respectively). The SO(2) in the UA of group G2 (56 +/- 17 %) was also greater than that in groups G1 (34 +/- 10 %) and SP (32 +/- 10 %). The sevoflurane concentrations at delivery in the MA, UV, and UA in group G2 were almost threefold higher than those in group G1, whereas all the newborns in the three groups had Apgar scores of 8 or more at 5 min, and the intraoperative blood loss did not differ among the groups. CONCLUSION: Sevoflurane anesthesia with 100% oxygen in elective cesarean delivery improves oxygen delivery to the fetus without severe neonatal depression, prolonged uterine relaxation, or increased blood loss.

Journal Article↗
PubMed1993

Neuromuscular effects of pipecuronium during sevoflurane anesthesia compared with isoflurane and enflurane anesthesia.

We evaluated the neuromuscular effects of pipecuronium during anesthesia with equipotent concentrations of either sevoflurane, isoflurane or enflurane. Twenty-seven patients scheduled for minor elective otolaryngeal or plastic surgery were studied and randomly assigned to 3 groups, one group per anesthetic agent. Anesthesia was induced with thiamylal 5 mg.kg(-1) and the trachea was intubated with succinylcholine 1 mg.kg(-1), then anesthesia was maintained with 60% nitrous oxide in oxygen and sevolfurane, isoflurane or enflurane, depending on the group. Neuromuscular blocking effects were monitored by recording the electromyographic activity of the adductor pollicis muscle from supramaximal stimulation of the ulnar nerve at 10-s intervals. Pipecuronium 40 microg.kg(-1) was administered when electromyographic activity had reached a stable state, 30 min after succinylcholine administration. The maximum effect (% block of control) and clinical duration (time to 25% recovery) of pipecuronium were 99.1 +/- 1.4% and 63.7 +/- 14.7 min (mean +/- S.D.) for sevoflurane, 99.0 +/- 2.0% and 60.9 +/- 20.5 min for isoflurane, and 98.0 +/- 2.5% and 62.8 +/- 28.7 min for enflurane, respectively. There were no significant differences in these values between the anesthetics. Cardiovascular stimulant effects were not observed in any of the groups. We conclude that the effect of pipecuronium under seveflurane anesthesia is similar to that under isoflurane and enflurane anesthesia.

Clinical Trial↗
PubMed1988

Effects of halothane and calcium entry blockers on atrioventricular conduction-a comparative study of verapamil, diltiazem, and nifedipine.

The effects of halothane on AV nodal function were evaluated in dogs with verapamil, diltiazem, or nifedipine during atrial pacing using the technique of His-bundle electrocardiography. Fifty-one mongrel dogs were divided into six groups. Anesthesia was induced with ketamine 100 mg im. and thiamylal 25 mg/kg iv. The animals were intubated and mechanically ventilated at normocapneic levels. Anesthesia was maintained with 50% nitrous-oxide in oxygen with pancuronium 2 mg im. Dogs in groups I, III, and V were anesthetized with 0.8% halothane and 50% nitrous-oxide in oxygen. We observed interactions between halothane and intravenous administration of either verapamil 0.1 mg/kg, diltiazem 0.15 mg/kg, or nifedipine 0.01 mg/kg respectively. Dogs in groups II, IV, and VI were administered either verapamil, diltiazem, or nifedipine iv without halothane. There were prolongations of sinus cycle length (SCL) (414 +/- 10 to 542 +/- 19 msec.), atrium-His (AH) interval (73 +/- 3 to 97 +/- 5 msec.), and functional refractory period (FRP) of the AV-node (227 +/- 5 to 260 +/- 5 msec.) in halothane anesthesia in groups I, III, and V. There were more prolongations of these variables after iv administration of verapamil (SCL; 617 +/- 35, AH; 118 +/- 7, FRP of the AV node; 311 +/- 4) and diltiazem (SCL; 554 +/- 19, AH; 118 +/- 12, FRP of the AV node; 283 +/- 12) but no prolongations after nifedipine (SCL; 533 +/- 19, AH; 99 +/- 8, FRP of the AV node; 272 +/- 9). Comparing effects of calcium entry blockers with and without halothane in groups I and II, III and IV, or V and VI, there were additive depressing effects of halothane with either verapamil or diltiazem on AV nodal function. And there is a difference between the effects of nifedipine on SCL with and without halothane.

Journal Article↗