Barbiturates* ; Brain* ; Membranes* ; Phospholipids*

Barbiturates* ; Brain* ; Membranes*

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* ; Cholesterol* ; Membranes* ; Phospholipids*

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*

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

BACKGROUND: Thiopental sodium and midazolam are frequently used to induce anesthesia. It has been known that barbiturates enhance the binding of benzodiazepines to the benzodiazepine receptors and also enhance the anesthetic effect of benzodiazepines. As a results, the combined effect of a barbiturate and a benzodiazepine should be more than the sum of the separate effects of the two drugs. The purpose of this study was to evaluate hypnotic interaction between the two drugs during induction period. METHODS: The effect of midazolam on the induction dose-response curve for thiopental sodium was studied in unpremedicated 240 ASA physical status I and II female patients. As an endpoint of hypnosis, ability to open eyes on command was used. Dose-response curves for thiopental sodium, midazolam, and their combination were determined with a probit procedure and compared with a isobolographic analysis. RESULTS: For hypnosis, significant(P<0.05) synergistic interaction was found between the two drugs. The dose of thiopental sodium required to produce hypnosis was reduced by 64% in the presence of equi-effective dose of midazolam. CONCLUSIONS: The interaction between thiopental sodium and midazolam for hypnosis is synergistic.
Anesthesia* ; Anesthetics ; Barbiturates ; Benzodiazepines ; Female ; Humans ; Hypnosis ; Hypnotics and Sedatives ; Midazolam* ; Receptors, GABA-A ; Thiopental*

Direct surgical repair of complex intracranial vascular lesions is difficult. Sometimes the neurosurgery is performed under circulatory arrest, profound hypothermia and barbiturates cerebral protection. Total ischemia is tolerated for 30~60 minutes because oxygen requirements of the brain decrease exponentially as body temperature is lowered. We experienced that this technique was successfully used for inoperable basilar artery aneurysm. We reviewed the surgical and anesthetic considerations of basilar artery aneurysm.
Aneurysm* ; Barbiturates ; Body Temperature ; Brain ; Hypothermia* ; Intracranial Aneurysm ; Ischemia ; Neurosurgery ; Oxygen

The incidence of life-threatening anaphylactoid reactions during anesthesia has been increasing. Specific allergic reactions during anesthesia are usually due to muscle relaxants, barbiturates, local anesthetics, narcotics, radiocontrast media, antibiotics, and colloids. Thrombokinase, a hemostatic agent, has been used widely in clinical practice and severe anaphylactoid reactions to thrombokinase can occur rarely. We experienced two cases of anaphylactoid reactions after thrombokinase administration.
Anesthesia ; Anesthetics, Local ; Anti-Bacterial Agents ; Barbiturates ; Colloids ; Contrast Media ; Factor Xa* ; Hypersensitivity ; Incidence ; Narcotics ; Pharmacology