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Acute metabolic effects of thiopental anesthesia on fed and fasted rats chronically treated with bromocriptine.

We investigated the acute effects of thiopental anesthesia (4 mg/100 g, i.v.) on plasma glucose, insulin, triacylglycerol, and prolactin levels in rats treated with bromocriptine (BR) (0.4 mg/100 g body wt, i.p., for two weeks). Thiopental anesthesia induced a rapid increase in plasma insulin that was more pronounced in the animals treated with BR (116%, P <0.05). Thiopental anesthesia also produced a 55% decreased in plasma prolactin levels (P <0.01) in control fed rats, and a 22% reduction in plasma triacylglycerol (P <0.05) in both controls and BR-treated rats. We conclude that BR may constitute and additional sympatholytic factor in animals submitted to thiopental anesthesia.

Anesthesia↗

Adjuvant effect of melatonin on anesthesia induced by thiopental sodium, ketamine, and ether in rats.

This study evaluated the anesthetic effects of thiopental sodium, ketamine, and ether with concurrent administration of melatonin. The loss of righting reflex was taken to assess the onset of anesthesia. Melatonin (20 mg/kg, p.o.) potentiated the anesthetic effects of thiopental sodium (20 mg/kg, i.v.) and ketamine (50 mg/kg, i.p.). Melatonin pretreatment caused rapid onset of anesthesia after ketamine and thiopental sodium administration while the duration of action of these agents was prolonged. Melatonin failed to alter anesthetic effects of ether (2 mg/kg by open method) in rats. This study suggests that melatonin modulate mechanisms involved in induction of thiopental sodium and ketamine anesthesia.

Adjuvants, Anesthesia↗

Interaction between thiopental and fentanyl in mice is different between hypnotic and lethal doses.

Much is known about the interaction of intravenous anesthetics and opioids at the therapeutic level, but less is known regarding their combined lethal effect, leaving some uncertainty regarding the window of safety for their clinical use. We set out to document the type of interaction between thiopental and fentanyl for both the hypnotic effect (loss of righting reflex) and lethal effect in mice. Hypnotic and lethal dose-response curves were constructed for thiopenthal alone and in combination with fentanyl (0.8 microg/kg, each based on five to seven subgroups of six to ten ICR mice. The dose of fentanyl was that needed to double the lag time to tail flick following a noxious stimulus (the equivalent of human analgesia). While fentanyl did not change the median effective hypnotic dose of thiopental (8.9 mg/kg [95% confidence interval {CI} 8.0-9.9 mg/kg] alone versus 7.8 mg/kg [95% CI 6.7-8.7 mg/kg] in combination), it significantly reduced its median lethal dose from 71.8 mg/kg (95% CI 68.3-74.8 mg/kg) to 64.5 mg/kg (95% CI 63.7-65.2 mg/kg). Most remarkably, it increased the slope of the curve from 0.17 (95% CI 0.10-0.36) to 0.61 (95% CI 0.24-1.10), virtually eliminating the difference between the non-lethal and lethal ranges. We conclude that the type of interaction between thiopental and fentanyl is stronger for the lethal effect than for the hypnotic effect. This may become relevant to clinical situations in humans when higher doses of thiopental are used.

Anesthetics, Intravenous↗

Effect of intravenous diazepam and thiopental on voluntary saccades and pursuit eye movements.

The effects of diazepam and thiopental on voluntary saccades and pursuit eye movements were tested in 9 volunteers, with an interval of at least 2 weeks between tests. One, 4 and 8 h after intravenous injection of diazepam (0.3 mg/kg) or thiopental (6.0 mg/kg), voluntary saccades and pursuit eye movements were tested and blood samples taken for analysis of drug concentration. As compared to results of tests without drugs, a significant reduction both of saccadic peak velocity and gain of pursuit eye movements was found 1 h after injection of either drug, but not after 4 and 8 h. The amplitude of saccades elicited with the 60 degrees stimulus was significantly reduced 1 h after injection of diazepam. Latency of saccades increased significantly up to 4 h after injection of either drug. No significant correlation was found between peak velocity of saccades and blood concentration of either thiopental or diazepam 1 h after administration. The present results confirm that in man saccades and pursuit eye movements are reduced by benzodiazepines and barbiturates, but provide no support for the previously described efficacy of saccades in monitoring the effect of benzodiazepines. It is hypothesized that diazepam and thiopental also induce reduction of voluntary saccades and pursuit eye movements via a general sedation of the central nervous system (CNS), besides having specific effects on CNS structures important to the performance of voluntary eye movements.

Adult↗

Pharmacoeconomics of propofol versus thiopental for induction of anaesthesia in short procedures.

This study compared the costs and benefits of using propofol/fentanyl versus thiopental/fentanyl for induction of anaesthesia in short procedures. A prospective, cohort trial was conducted in conjunction with a patient survey. The study population included a consecutive sample of American Society of Anaesthesiologists. Class I or II patients who underwent short operative procedures and who were given one of the studied anaesthetic regimens. Insoflurane/N2O was used for maintenance of anaesthesia in all cases. Propofol patients showed a significantly shorter time to eye opening (p = 0.0025); orientation to date of birth, place, and day of week (p = 0.0002); time to consciousness (p = 0.0019); and time in recovery room (p = 0.013); but not time to tolerating 50 mL of oral fluid (p = 0.06). Nausea and vomiting occurred in 41% of thiopental patients and 19% of propofol patients (difference 22%; 95% C.I., -1% to 44%). Based on survey results, propofol patients subjectively reported fewer side effects upon returning home and were able to resume daily activities earlier than thiopental patients. With the current staffing and patient load at our institution, an estimated 4.8 hours of nursing time per day would be made available if propofol were used in place of thiopental for induction of anaesthesia in these procedures. If propofol were used for all daycare surgery patients in our institution, the annual acquisition cost is projected to be $60,331.28 versus $8,079.68 for thiopental.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Depression of I waves in corticospinal volleys by sevoflurane, thiopental, and propofol.

UNLABELLED: Isoflurane depresses the number and amplitude of I waves of the motor-evoked potential produced by transcranial electrical stimulation of the motor cortex and thus affects components of the corticospinal volley that are believed to arise from Laminae III and V. This study extends these observations to sevoflurane (9 patients) and the two IV anesthetics, thiopental and propofol (10 sets of observations in 10 and 6 patients, respectively). The patients' ages ranged from 10 to 17 yr. Sevoflurane was administered to achieve end-tidal concentrations of 0.5%-3%. Thiopental and propofol were given as boluses of 5 mg/kg and 2 mg/kg, respectively, to patients anesthetized with nitrous oxide, fentanyl, midazolam, and a muscle relaxant. Sevoflurane had a depressant effect on I waves essentially similar to that of isoflurane; thiopental depressed I wave activity by an average of 33% (95% confidence interval: 20%-46%, P < 0.001) and propofol by 39% (95% confidence interval: 20%-40%, P < 0.001). With all three anesthetics, later I waves showed the most amplitude depression. The three anesthetics had qualitatively similar effects on I waves. IMPLICATIONS: Sevoflurane, thiopental, and propofol depress components of the corticospinal volley produced by transcranial electrical stimulation of motor cortex in a manner qualitatively similar to isoflurane. The findings indicate that anesthetics with primarily hypnotic actions suppress interneuronal activity in cerebral cortex.

Adolescent↗

Effects of propofol, midazolam and thiopental sodium on outcome and amino acids accumulation in focal cerebral ischemia-reperfusion in rats.

OBJECTIVE: To investigate the effects of propofol, midazolam and thiopental sodium on outcomes and amino acid accumulation in focal cerebral ischemia-reperfusion in rats. METHODS: Male Sprague Dawley (SD) rats were scheduled to undergo 3-hour middle cerebral artery occlusion by intraluminal suture and 24-hour reperfusion. Neurologic outcomes were scored on a 0-5 grading scale. Infarct volume was shown with triphenyltetrazolium chloride staining and measured by an image analysis system. Concentrations of various amino acids (aspartate, glutamate, glycine, taurine, and gama-aminobutyric acid) were measured after 3 hours of reperfusion using high performance liquid chromatography. Propofol, midazolam and thiopental sodium were given intraperitoneally at the beginning of reperfusion. RESULTS: Both propofol and midazolam attenuated neurological deficits and reduced infarct and edema volumes. Propofol showed better neurological protection than midazolam while thiopental sodium did not exhibit any protective effect. Both propofol and midazolam decreased excitatory amino acids accumulation, while propofol increased gama-aminobutyric acid accumulation in ischemic areas in reperfusion. CONCLUSION: Propofol and midazolam, but not thiopental sodium, may provide protective effects against reperfusion induced injury in rats subjected to focal cerebral ischemia. This neurological protection may be due to the acceleration of excitatory amino acids elimination in reperfusion.

Adenosine Triphosphate↗

Effects of ketamine, midazolam, thiopental, and propofol on brain ischemia injury in rat cerebral cortical slices.

AIM: To compare the effects of ketamine, midazolam, thiopental, and propofol on brain ischemia by the model of oxygen-glucose deprivation (OGD) in rat cerebral cortical slices. METHODS: Cerebral cortical slices were incubated in 2 % 2,3,5-triphenyltetrazolium chloride (TTC) solution after OGD, the damages and effects of ketamine, midazolam, thiopental, and propofol were quantitatively evaluated by ELISA reader of absorbance (A) at 490 nm, which indicated the red formazan extracted from slices, lactic dehydrogenase (LDH) releases in the incubated supernate were also measured. RESULTS: Progressive prolongation of OGD resulted in decreases of TTC staining. The percentage of tissue injury had a positive correlation with LDH releases, r=0.9609, P<0.01. Two hours of reincubation aggravated the decrease of TTC staining compared with those slices stained immediately after OGD (P<0.01). These four anesthetics had no effects on the TTC staining of slices. Ketamine completely inhibited the decrease of A value induced by 10 min of OGD injury. High concentrations of midazolam (10 micromol/L) and thiopental (400 micromol/L) partly attenuated this decrease. Propofol at high concentration (100 micromol/L) enhanced the decrease of A value induced by 10 min of OGD injury (P<0.01). CONCLUSION: Ketamine, high concentration of midazolam and thiopental have neuroprotective effects against OGD injury in rat cerebral cortical slices, while high concentration of propofol augments OGD injury in rat cerebral cortical slices.

Anesthetics, Intravenous↗

Effects of thiopental and propofol on heart rate variability during fentanyl-based induction of general anesthesia.

Anesthetics depress the autonomic nervous system. The effects of thiopental and propofol on heart rate variability (HRV) during fentanyl-based induction of general anesthesia were studied in one hundred patients. We observed different effects of fentanyl, thiopental and propofol on HRV. Fentanyl decreased total power of HRV and low frequency power (LF), but not high frequency power (HF), indicating a greater reduction of cardiac sympathetic activity. Thiopental and propofol caused the further reduction of HRV and decreased HF power. Thiopental increased LF power and LF/HF ratio, indicating that the vagolytic effect is associated with the increase in sympathetic activity. Propofol preserved the LF power, indicating that the cardiac parasympathetic activity is reduced more than the sympathetic activity.

Adult↗

Reduction of gain and time constant of vestibulo-ocular reflex in man induced by diazepam and thiopental.

The effect of intravenous administration of two sedatives, diazepam (0.3 mg/kg) and thiopental (6.0 mg/kg), on the vestibulo-ocular reflex (VOR) in man was investigated on 9 volunteers. The VOR was evoked with a velocity step rotation test and gain and time constant of prerotatory and postrotatory nystagmus were measured. Both drugs reduced VOR gain. Diazepam-induced reduction lasted 8 h and thiopental-induced reduction 1 h. A reduction of the VOR time constant was found lasting about 1 h for both drugs, but with a tendency for the thiopental effect to last longer. These findings, not previously described in man, differ from what has been found in macaques and rabbits injected with diazepam. The reduction of gain and time constant were not correlated with the blood concentration of either drug. The present results suggest that in man the VOR gain and time constant are both reduced by different types of sedatives although with different time courses. On the basis of previously shown effect of alertness on the VOR, it is hypothesized that diazepam and thiopental, besides having a specific effect on central nervous system structures important to the VOR, also induce reduction of the VOR through a general sedation of the CNS.

Adult↗

[Comparative study between propofol and thiopental for anesthesia induction in surgery of short duration].

To compare anesthetic characteristics of thiopental and propofol in short duration surgical interventions, we have studied 40 patients undergoing gynecologic and proctologic surgery. Patients were randomly assigned to two groups receiving 2.5 mg/kg of propofol or 5 mg/kg of thiopental. In both groups, arterial hypotension of comparable intensity occurred. Heart rate was significantly higher in thiopental anesthesia. Postanesthesia recovery was significantly more rapid with propofol. Some of these results can be influenced by the different immediate premedication (atropine and diazepam in thiopental group) and duration of anesthesia.

Adult↗

Increased binding of thiopental in tissue homogenates of the rat in the presence of a volatile anesthetic.

Thiopental (CAS 76-75-5) binding (0.4 mmol.l-1) in tissue homogenate of rats (liver, brain, heart, kidney, lung, spleen and skeletal muscle) was studied by equilibrium dialysis. Percentage of thiopental bound was relatively low in homogenate of brain, lung, spleen and skeletal muscle (14-19%); it was much higher in that of liver, heart and kidney (24-27%). Simultaneously present halothane (11.8 mmol.l-1) increased the percentage of thiopental bound in the homogenate of all tissues investigated at least to a factor of 1.4 (spleen) and maximally of 2.4 (brain). The same phenomenon of an increased thiopental binding in tissue homogenate was found in the presence of 10.3 mmol.l-1 enflurane (except skeletal muscle) and 10.2 mmol.l-1 isoflurane (except kidney, spleen and skeletal muscle), yet to a significantly lower extent in the presence of these halogenated ethers as compared with halothane.

Anesthetics↗

[Comparative study of propofol with thiopental and etomidate in anesthetic induction].

Anesthetic characteristics were studied in three homogeneous groups of twenty patients ASA I who underwent intravenous anesthetic induction with propofol 2 mg/kg; thiopental 5 mg/kg; or etomidate 0.3 mg/kg. The unconsciousness time was similar in the three groups, whereas awaking time and time of response and orientation were longer after thiopental and etomidate than after propofol. Intravenous injection of the three anesthetic agents was followed by a decrease in systolic and diastolic arterial pressure. Heart rate increased after thiopental and etomidate and had only slight fluctuations after propofol. After tracheal intubation there was a significant increase in systolic and diastolic arterial pressure and heart rate in thiopental and etomidate group. These changes were minimal after propofol. The highest number of complications occurred after etomidate.

Adult↗

Study on the effects of six intravenous anesthetic agents on regional ventricular function in dogs (thiopental, etomidate, propofol, fentanyl, sufentanil, alfentanil).

This study evaluates the effects of 30 min increasing doses infusions of six intravenous anesthetic agents (thiopental, etomidate, propofol, fentanyl, sufentanil and alfentanil) on regional ventricular function in a normal and an acute ischemic heart segment in dogs. Part 1 discusses the methodology used in this experimental design with emphasis on the sensitivity and the limitations of the parameters used to assess ventricular performance and contractility. Part 2 reports the effects on regional and global ventricular function, which occur when one segment is made acutely ischemic. Part 3 reports and discusses the effects of increasing infusions of the three induction agents thiopental, etomidate and propofol on systemic and regional ventricular function. These agents induced a dose-dependent decrease in left ventricular end-systolic pressure. End-diastolic length also decreased in the normal and the acute ischemic segment for the three agents, indicating a decrease in left ventricular loading. This effect was most pronounced for propofol. At the doses tested, etomidate did not alter regional myocardial function significantly in any of the two segments. Thiopental, on the other hand was associated with a dose-dependent decrease in systolic shortening, that was significantly greater in the ischemic segment. This suggested that thiopental depresses myocardial function more in the acute ischemic heart than in the normal heart. Propofol decreased systolic shortening similarly in both segments. In part 4 the effects of the three narcotics fentanyl, sufentanil and alfentanil are reported. Fentanyl and sufentanil induced a dose-dependent decrease in heart rate. Left ventricular end-systolic pressure remained unchanged despite the increasing infusion rate. Fentanyl increased regional end-diastolic length and systolic shortening at the highest infusion rate. This phenomenon is not apparent for sufentanil, suggesting that different mechanisms are involved to compensate for the expected bradycardia-induced hypotension. Alfentanil did not alter systemic and regional hemodynamics significantly in this study design.

Alfentanil↗

Thiopental attenuates dysrhythmias in children: comparison of induction regimens.

Anesthesia was induced in 91 children using one of three induction regimens: (a) thiopental, atropine, and succinylcholine (T group); (b) halothane, atropine, and succinylcholine (H group); and (c) halothane, thiopental, atropine, and succinylcholine (H/T group). The incidence of dysrhythmias was significantly greater in the H group (85%) than in the T group (6%) and H/T group (20%). Fewer dysrhythmias occurred in the H/T group compared to the H group despite similarly prolonged QTc intervals in both groups. We conclude that induction of anesthesia with thiopental is appropriate and reduces the incidence of cardiac rhythm disturbances in children and that administration of thiopental to children during induction of anesthesia with halothane, atropine, and succinylcholine may reduce the incidence of cardiac dysrhythmias.

Anesthesia, General↗

Midazolam-thiopental anesthetic interaction in patients.

The effect of thiopental on the induction dose-response curve for midazolam was studied in nonpremedicated ASA physical status I and II patients. As an endpoint of anesthesia, ability to open eyes on command was used. Dose-response curves for thiopental, midazolam, and their combination were determined with a probit procedure and compared with an isobolographic analysis. Interaction between midazolam and thiopental was found to be synergistic (supraadditive). The degree of midazolam-thiopental anesthetic synergism in surgical patients was close to that reported previously in rats with loss of the righting reflex as an index of anesthesia.

Adult↗

Induction of general anesthesia with diazepam or thiopental: a comparison of the cardiorespiratory effects.

Detailed cardiorespiratory studies were performed in 10 volunteers in whom general anesthesia was induced with thiopental 3 mg/kg and diazepam 0.4 mg/kg.Minimal changes in blood pressure were noted with both agents. Depression of total peripheral resistance lasted in excess of 20 minutes with diazepam but had returned to control levels with thiopental, elevations in cardiac rate and output were most evident and lasted longer with diazepam. In the healthy volunteer induction of anesthesia with diazepam causes alterations in cardiovascular parameters which are more profound than with thiopental. The data presented is in contrast to that obtained when patients with cariovascular disease are studied.With diazepam, considerable individual variation and long recovery times were confirmed.Following extensive clinical use, a detailed study demonstrated minimal cardiovascular depression following intravenous induction of sedation with diazepam, in patients who had prior cardiovascular disease. Subsequent studies suggested that diazepam would be a more suitable alternative for induction of general anesthesia in patients with cardiovascular disease. This was confirmed by Ikram and Rubin. It has been used extensively for sedative techniques in dentistry, and therefore it was logical to extend this concept to the induction of general anesthesia by intravenous diazepam. It was decided to evaluate the use of intravenous diazepam for induction of general anesthesia and to compare the detailed cardiovascular and respiratory effects of this drug with thiopental.

Adult↗

Comparison of psychomotor skills and amnesia after induction of anesthesia with midazolam or thiopental.

In two groups of 31 healthy patients undergoing minor elective surgery, anesthesia was induced intravenously with either midazolam maleate, 0.2 mg/kg, or thiopental, 3.5 mg/kg. All subjects received 2 micrograms/kg fentanyl 5 min before the induction agents. Induction time with midazolam was significantly longer than with thiopental (97.1 +/- 10.9 sec vs 59.4 +/- 5.0 sec) and time to orientation postoperatively was significantly longer after midazolam (31.7 +/- 4.2 min vs 11.0 +/- 1.1 min). Continued recovery after orientation, measured by a series of psychomotor tests, was also significantly longer with midazolam than with thiopental. Anterograde amnesia was evident in 84.8% of the midazolam treated patients and in only 31.4% of the thiopental group. This degree of absence of recall was acknowledged positively by the affected patients. The protracted recovery period may limit the use of midazolam in short surgical procedures.

Adult↗