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An HPLC method is described for the determination of thiopental in serum. It offers the advantage of a simple extraction procedure and a low detection limit. Including sample preparation, the analysis takes 20 minutes. The within-run and between-run CV's were 1.5% and 3.8% respectively.
It has been demonstrated in experiments on rabbits that anesthetic ether sodium thiopental, phentanyl and leucine-enkephalin have different inhibitory effects on the activity of inspiratory and expiratory neurons in the medulla oblongata. Bemegrid recovers the activity of the respiratory center inhibited by all the substances under study whereas naloxone eliminates apnea induced by phentanyl or leucine-encephalin alone. Besides, it has been ascertained that naloxone effectively abolishes the inhibition of the respiratory center caused by hyperventilation in rats.
Influences of chemical restraining agents of IV glucose tolerance test were studied in 3 cats. An IV injection of 0.5 g of glucose/kg produced hyperglycemia which was apparent at 15 minutes after the injection was done and disappeared at 45 minutes. All of the following drugs studied influenced the IV glucose tolerance test (0.5 g of glucose/kg): thiopental sodium (16 mg/kg, IV), ketamine (11 and 33 mg/kg, IM), acetylpromazine (2.2 mg/kg, IM), xylazine (2.2 mg/kg, IM), and morphine (0.1 mg/kg, IM). The results indicate that in cats glucose tolerance tests probably should be performed without chemical restraint. Data derived from tests where chemical restraint was used should be interpreted carefully, since the restraint drug, per se, may interfere with the test.
The biotransformation of halothane is supposed to be the cause of the rare "halothane-hepatitis". Therefore an inhibition of the metabolism of Halothane is of some interest. We used bromide as a metabolite of Halothane and investigated the bromide level of the serum of patients after halothane anaesthesia by means of x-ray fluorescence spectrometry. The induction of anaesthesia with Thiopental, Methohexital and Etomidate had no influence on the bromide level. Likewise the influence of Enflurane on the metabolism of Halothane was not significant. An effective inhibitor in man is Disulfiram. The authors assume, that further information about the toxicity of Halothane metabolites can be gained through further studies of drugs like Disulfiram.
OBJECTIVE: To compare two anesthetic protocols for maintenance of anesthesia during laryngectomy (propofol vs thiopental-isoflurane), assessing its effects on intraoperative hemodynamic stability and recovery time after withdrawal of anesthesia. PATIENTS AND METHOD: Thirty-one patients undergoing laryngectomy. Anesthetic technique was the same except for the maintenance anesthetic used (isoflurane in group I [n = 16]; propofol in group P [n = 15]). We recorded heart rate and systolic/diastolic arterial pressure before surgery, 10 minutes after induction, at 10, 60 and 120 min after start of surgery and at the end of the procedure. Postanesthesia recovery time was measured by the Steward test (recovery of consciousness, control of voluntary movement and of breathing) applied at 3, 5, 10, 30 and 60 min after withdrawal of anesthesia. RESULTS: There were no demographic differences between the two groups and heart rate and systolic/diastolic pressures were comparable. Postanesthetic recovery time was shorter in group P than in group I, with a statistically significant difference 5 min after withdrawal of drug (p < 0.05) owing to the item recovery of consciousness in the Steward test (p < 0.05 at times 5 and 10 min for this item). There were no significant differences in control of breathing or movement. CONCLUSIONS: Propofol for anesthetic maintenance is effective and safe. There are no differences in hemodynamic changes produced by propofol and isoflurane. Time until recovery of consciousness is longer with isoflurane, although we believe that this is not clinically relevant in this type of procedure.
We describe an isothermal gas-liquid chromatographic procedure developed for measuring thiamylal and thiopental in plasma. The unchanged drug is extracted into ethyl acetate from acidified plasma, together with an internal standard. The solvent is removed, the residue methylated, aliquots, diluted with benzene, are injected into a 183-cm gas-liquid chromatographic column containing 3% OV-17. Sensitivity of detection is in the nanogram to picogram range.
We compared the patient's response to laryngeal mask (LM) insertion and hemodynamics among three anesthesia induction methods; P group using 2.5 mg.kg-1 propofol with 0.2 microgram.kg-1 fentanyl, M group using 0.2 mg.kg-1 midazolam with 0.2 microgram. kg-1 fentanyl, B group using 5 mg.kg-1 thiopental with 0.2 microgram.kg-1 fentanyl. Each 30 patients, 35 to 65 years, for elective mastectomy were entered in three groups. Preanesthetic medication was i.m. injection of 0.5 mg atropine and 5 mg midazolam 30 min before the induction. Anesthesia was induced with intravenous injection of each dose of P, M or B in 20 sec followed by fentanyl. When verbal response disappeared, a laryngeal mask was inserted. The number of patients with difficult insertion or showing body movement or gagging were larger in the order of M group > B group > P group. Blood pressure and heart rate in the P group were significantly lower than those in the other two groups. It was concluded that P allowed the most smooth insertion of LM among the three groups, but it also induced hypotension and bradycardia.
The 60 MHz (1)H NMR spectra of racemic thiopental, 1, have been studied with the achiral shift reagent, tris(6,6,7,7,8,8,8-heptafluoro-2,2-dimethyl-3,5-octanedionato) europium(III), 2, and the chiral tris[3-(trifluoromethylhydroxymethylene)-d-camphorato] europium(III), 3, and tris[3-(heptafluoropropylhydroxymethylene)-d-camphorato] europium(III), 4. Enantiomeric shift differences, DeltaDeltadelta, were clearly observed for all three methyl signals of 1 with 3 or 4, with larger values obtained using the former reagent. Thus, a 0.216 molal solution of 1 in CDCl(3) at 28 degrees C with a 3:1 molar ratio of 0.359 displayed DeltaDeltadelta values of about 17 Hz for the proximal methyl of the methylbutyl group (at the chiral centre), 13 Hz for the CH(3) of the ethyl group, and 6 Hz for the distal CH(3) of the methylbutyl group. Results are compared for those obtained with 2 and 3 using secobarbital, talbutal, butabarbital and pentobarbital.
Sixty otherwise healthy patients with no clinical signs of intracranial hypertension who were undergoing elective intracranial surgery were randomly assigned to receive anesthesia with either thiopental, 3-6 mg/kg i.v., and isoflurane, 0.5-1.5% (group 1, N = 30) or propofol, 1-2.5 mg/kg i.v., and propofol infusion, 40-200 microg/kg/h (group 2, N = 30). Both groups received 50% nitrous oxide in O2 subsequent to dural opening. During induction, the changes in heart rate (HR), mean arterial pressure (MAP), cerebrospinal fluid pressure (CSFP), and cerebral perfusion pressure (CPP) were similar between the groups, except at 3 min when the findings (mean +/- SEM) for CPP (81 +/- 3.3 vs. 70.3 +/- 2.8 mm Hg, p <0.05) were significantly lower in group 2. At intubation, the highest level of MAP (103.1 +/- 3.3 vs. 88.9 +/- 2.7 mm Hg, p <0.05) was significantly greater in group 1. At pinhead-holder application, the highest values of HR (81.8 +/- 3 vs. 73.9 +/- 2.1 beats/min, p <0.05), MAP (112.2 +/- 3.6 vs. 98.3 +/- 3 mm Hg, p <0.05), CSFP (15.2 +/- 1.3 vs. 11.6 +/- 1.1 mm Hg, p <0.05), and CPP (97.0 +/- 3.9 vs. 86.7 +/- 3.3 mm Hg, p <0.05) were significantly greater in group 1. During early (20-30 min) recovery, group 2 had higher Glasgow Coma Scale scores and a greater percentage of patients in whom eye opening, response to commands, extubation, speech, and time/space orientation were present. In conclusion, when compared to thiopentalisoflurane for intracranial surgery, propofol produces similar HR, MAP, CSFP, and CPP responses during induction, adequate control of these responses during nociceptive stimulation, and faster recovery for cerebral function postoperatively.
A series of experiments were conducted to investigate the effect of the monoamine oxidase inhibitor (MAOI), phenelzine, on thiopental anesthesia, electroshock, and blood pressure. After demonstrating that phenelzine (1 mg/kg/day orally) produced the same decrease in pig platelet monoamine oxidase as seen in humans, we compared MAOI-treated vs. non-MAOI-treated groups of pigs following anesthesia and electroconvulsive shock (ECS). In the majority of pigs, the increase in blood pressure associated with general anesthesia and ECS is no greater after MAOI treatment than after no MAOI treatment. One phenelzine-treated pig demonstrated an excessive catecholamine surge and elevated blood pressure.
Previous reports of a much greater incidence of arrhythmias with thiopental anesthesia for electroconvulsive therapy (ECT) compared to methohexital were reexamined and the possible role of hypercapnia reconsidered. Review of 50 treatments with each agent in 13 patients who had received each at our facility revealed only one brief episode of arrhythmia. The importance of postictal hyperventilation in preventing hypercapnia and associated arrhythmias was suggested.
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