Millions of injection of sodium thiopental have been clinically used since it was introduced by Lundy in 1934. As with other barbiturates, cutaneous allergic manifestation are rather frequently seen, but reports of anaphlyactic reactions are rare. Probably many cases have not been recognized or have been misdiagnosed. It is believed that some cases of unexplained collapse or even death after thiopental inductions are very possibly due to an unrecognized anaphylactic action. This report presents a case of anaphylactic action due to injection of sodium thiopental and the references were reviewed.
Anaphylaxis* ; Barbiturates ; Sodium ; Thiopental*

Barbiturates* ; Brain* ; Membranes* ; Phospholipids*

Barbiturates* ; Brain* ; Membranes*

Barbiturates* ; Brain* ; Cholesterol* ; Membranes* ; Phospholipids*

Fixed drug eruption normally presents as single or multiple sharply demarcated erythematous lesions that recur at the same location upon re-exposure to the offending agent. When the acute inflammation subsides, it often leaves residual hyperpigmentation. Commonly implicated substances are phenolphthalein, barbiturates, sulfonamides, tetracyclines, salicylates, gold and pyrazolone derivatives. Despite frequent use of acetaminophen, drug eruptions, especially fixed drug eruptions, due to acetaminophen are extrernely rare. We report here a childhood case of fixed drug eruption caused by acetaminophen, which is extensively used as an over-the-counter drug, as well as in medical therapy.
Acetaminophen* ; Barbiturates ; Drug Eruptions* ; Hyperpigmentation ; Inflammation ; Phenolphthalein ; Salicylates ; Sulfonamides ; Tetracyclines

Bilateral traumatic carotid-cavernous fistulae (TCCFs) is rarely encountered neurovascular disease. For treatment of TCCF, detachable balloons have been widely used. Nowadays, transarterial and/or transvenous coil embolization with placement of covered stents is adopted as another treatment method. We experienced a patient with a bilateral TCCFs who was successfully treated with covered stents. However, cerebral hemorrhage occurred in the bed of previous infarction one day after treatment. Hyperperfusion syndrome was considered as a possible cause of the hemorrhage, so that barbiturate coma therapy was started and progression of hemorrhage was stopped. We emphasize that cerebral hyperperfusion hemorrhage can occur even after successful endovascular treatment of TCCF.
Barbiturates ; Caves ; Cerebral Hemorrhage ; Coma ; Fistula ; Hemorrhage ; Humans ; Infarction ; Stents

The capacity of hypothermia to protect the brain during a period of decreased or absent oxygen delivery(hypoxia) is well established both experimentally and clinically. And also experimentally, barbiturates, which are the most potent pharmacologic depressants of cerebral metabolism, do provide protection. A 25 year-old patien, who had suffered from hypoxic cerebral hypoxia was satisfactorily treated by a combination therapy with Thiopental Sodium and low-grade Hypothermia.
Adult ; Barbiturates ; Brain ; Humans ; Hypothermia* ; Hypoxia, Brain* ; Metabolism ; Oxygen ; Thiopental*

Three groups of healthy adults were premedicated with diaxepam or secobarbital and anesthetized with propanidid or thiopental. The concentration of serum potassium wes measured before induction and after succinylchaline iodide administration. The increases of potassium in diazepam-thiopental, diaxepam-propanidid and secobarbital propanidid groups were 0. 14, 0. 06, and 0. llmEq/L (3. 29, l. 38 and 2. 58%) respectively. Serum potassium changes were least in diazepam-propanidid group, but there were no significant differences among the 3 groups. The choice of induction agent is of importance for the changes in serum potassium which follow the subsequent injection of succinylcholine iodide. For instance, intravenous induction by barbiturate is followed by a lesser increase in serum potassium after succinylcholine injection than induction by halothane. As barbiturates are so commonly used as intravenous induction agents, we chose thiopental and succinylcholine iodide as standard with which to compare the other induction agents, propanidid and succinylcholine iodode. And also, we wanted compare two premedicants, secobarbital and diaepam. The results were as follows: (1) The thiopental-succinylcholine iodide group and the propaaidid-succinylcholine iodide group revealed no significant differences in serum potassium level. (2) There was a lesser increase in serum potoassium level after premedication with diazepam than premedicstion with secobarbital in the propanidid-succinylcholine iodide group. (3) Induction by propanidid succinylcholine iodide and premedication by diazepam are recommendable for least increasing the serum potassium level.
Adult ; Barbiturates ; Diazepam ; Halothane ; Humans ; Potassium* ; Premedication ; Propanidid ; Secobarbital ; Succinylcholine ; Thiopental

OBJECTIVE: Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with Bispectral(TM) index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. METHODS: We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. RESULTS: The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were 0.63 +/- 0.26 in low dose group, and 1.31 +/- 0.48 in high dose group. The treatment durations were 4.89 +/- 1.68 days and 3.38 +/- 1.24 days in low dose BCT and high dose BCT, respectively. CONCLUSION: It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.
Anesthesia, General ; Barbiturates ; Coma ; Heart Arrest ; Humans ; Hypokalemia ; Hypotension ; Incidence ; Intracranial Hypertension ; Intracranial Pressure ; Potassium ; Thiopental

The effects of halothane or isoflurane, alone and in combination with propofol or thiopental were investi Rated for their effects on intracranial pressure QCP) in the rabbit, with inducing artificially-increased ICP with intracranial balloon. The higher the end-tidal concentrations of either halothane or isoflurane, the lower the mean arterial pressures(MAP) and cerebral perfusion pressures(CPP). However, the ICP was not influenced by the depth of anesthesia for either inhalation anesthetics. The mean ICPs at 1.5 MAC of halothane and isoflurane were 14+/-2 and 20+/-2mmHg, respectively. With the increase of intracranial volume using 0.7 ml-saline balloon, the ICPs were increased to 193 and 205% in halothane and isoflurane anesthesia, respectively. The ICPs were returned to the levels prior to balloon inflation by the injection of thiopental or propofoL The authors conclude that propofol could be used to reduce ICP under halothane or isoflurane anesthesia if it is ascertained to have the characteristics of balanced coupling between cerebral metabolism and blood flow like barbiturates do and either halothane or isoflurane with increasing the concentrations may decrease MAP without significant change of ICP.
Anesthesia* ; Anesthetics, Inhalation ; Barbiturates ; Halothane* ; Inflation, Economic ; Intracranial Pressure* ; Isoflurane* ; Metabolism ; Perfusion ; Propofol* ; Thiopental*