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*

BACKGROUND: Succinylcholine is still the most frequently used muscle relaxant for rapid-sequence intubation despite its well-known side effects. Rocuronium has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence intubation. The purpose of this study was to compare tracheal intubating conditions by following different rocuronium doses and application techniques versus succinylcholine. METHODS: Fifty nine ASA physical status 1 and 2 adult patients scheduled for elective surgeries were anesthetized with thiopental sodium 5 mg/kg and muscle relaxant using a rapid-sequence technique. Group I (n = 12) received succinylcholine 1.0 mg/kg, group II (n = 15) received rocuronium 1.0 mg/kg, group III (n = 16) received rocuronium 0.6 mg/kg as a single bolus dose, and group IV (n = 16) received a priming dose of rocuronium 0.06 mg/kg followed three minutes later by rocuronium 0.54 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxant and intubating conditions were evaluated by clinical scoring (Table 1), and train-of-four (TOF) count of the adductor pollicis by accelerography. RESULTS: TOF counts of group I were lower than those of groups III and IV, and those of group II were lower than group III (P < 0.0083). Group II had intubating conditions similar to group I. The intubating conditions of groups I and II were better than those of groups III and IV (P < 0.0083). CONCLUSIONS: Rocuronium 1.0 mg/kg may be a suitable alternative for succinylcholine 1.0 mg/kg during rapid-sequence intubation. Priming principle does not produce faster or better intubating conditions than a single bolus injection.
Adult ; Humans ; Intubation* ; Succinylcholine ; Thiopental

No abstract available.
beta-Endorphin* ; Cardiopulmonary Bypass* ; Thiopental*

The present study was undertaken to measure the effects of thiopental and thiamylal on isolated thoracic aortic hlical strips in normotensive Wistar rats(NWR) and spontaneously hypertensive rats(SHR). Phenylphrine(10(-9) ~ 10(-5) M) caused a dose-dependant contraction in thoracic aortic strips contracted with 30mM KCI in NWR and SHR. The contraction induced by 30mM KCI was taken as 100% and the mean absolute values of NWR and SHR were 463+/-30 and 457+/-38mg, respectively. The ED50 of phenylphrine in thoracic aortic strips contracted with 30mM KCI in NWR and SHR was (2.3+/-1.2) X 10(-8) M and (2.1+/-1.1) X 10(-9) M, respectively. There were no significant differences in the contractile response of thoracic aorta from NWR and SHR to 30mM KCI. In helically cut strips of thoracic aorts contracted with 30mM KCI, the cumulative administration of thiopental (10(-5) ~ 10(-3) M) caused a dose related contraction in NWR and SHR. The contraction induced by 30mM KCI was taken as 100% and the mean absolute values of NWR and SHR were 496+/-31 and 541+/-69mg, respectively. There were significant differences (p<0.05 and p<0.01) in the contractile responses of thoracic aorta from NWR and SHR to thiamylal(3X10(-4) and 10(-3) M). The dose-related contraction to thiamylal was greater than that to thiopental in NWR and SHR.
Aorta, Thoracic* ; Rats, Inbred SHR* ; Thiamylal* ; Thiopental*

Effect of succinyleholine on the intra-ocular pressure was assessed in 29 surgical patients. After pretreatment of thiopental in a dose to induce the loss of eye-lid reflex the intra- ocular pressure was measured following intravenous administrdtion of succinylcholine. The following were the results. 1) Thiopental showed a significant lowering effect on the intra-ocular pressure. 2) A small dose(0.5mg/kg) of succinylcholine, given immediately after thiopental restored the intra-ocular pressure to the preanesthetic level. 3) A large dose(1.0~2.0mg/kg) of succinylcholine, administered immediately after thiopental, sustained the intra-ocular pressure below the preanesthetic leve. 4) Teacheal intubation caused a rise of the intra-ocular pressure above the preanesthetic level, more significantly than that of succinyleholine. 5) Suecinylcholine, in a large dose, showed a depressing effect on elevation of the intraocular pressure induced by tracheal intubation.
Humans ; Intraocular Pressure ; Intubation ; Reflex ; Succinylcholine* ; Thiopental

The effect of a new analeptic, doxapram hydrochloride, on respiration has been studied in ten subjects anesthetized with thiopental or with nitrous oxide-oxygen-halothane. The results are as follows: 1) Respiratory stimulation was more pronounced in the group anesthetized with thiopental than that with nitrous oxide-oxygen-halothane. 2) The stimulatory effect lasted for four minutes. Subjects who received multiple doses of the drug, however, showed a cumulative effect. 3) Most cases showed moderate hypertensive effect and brief electrocardiographic change was observed in one of the ten.
Anesthesia, General* ; Doxapram* ; Electrocardiography ; Respiration* ; Thiopental

BACKGROUND: The purpose of this study was two fold; first, to determine the incidence and type of withdrawal movement associated with IV injection of rocuronium in pediatric patients; and second, to determine whether pretreatment with IV lidocaine affects the incidence of movement associated with rocuronium administration in pediatric patients. METHODS: Forty-two pediatric patients were randomly assigned to two groups. After general anesthesia was induced with thiopental sodium 5 mg/kg and manual occlusion of venous inflow was performed, one group of patients received 0.1 ml/kg 1% lidocaine IV. A second group received 0.1 ml/kg of normal saline as a placebo control. Venous inflow occlusion was held for 5 seconds, and immediately followed by the injection of rocuronium 0.6 mg/kg IV. The patient's response to rocuronium injection was graded using a 5-point scale. RESULTS: We observed that the incidence of movement was 100% in the placebo group and was significantly decreased to 28.8% in the group pretreated with lidocaine (P<0.001). CONCLUSIONS: Withdrawal movement on injection of rocuronium in pediatric patients can be decreased or prevented by pretreatment with IV lidocaine.
Anesthesia, General ; Child* ; Humans ; Incidence ; Lidocaine* ; Thiopental

No abstract available.
Antioxidants* ; Propofol* ; Reactive Oxygen Species* ; Thiopental* ; Vasodilation*

In view of the current trend towards carrying out termination of pregnancy as day cases it is also important that the patient should be free from pain with a rapid recovery from anesthesia and a minimum of post operative sequalae. We compared the effects of three other anesthetic techniques for the termination of pregnancy in 100 healthy womes as day cases. 1) Anesthesia with thiopental sodium alone was associated with a high score of pain sensation(2+/-0.93) and with considerably rapid recovery(103+/-57.6 mins). 2) The combination of thiopental sodium and meperidine was associated with a lower score of pain sensation(1.58+/-0.8) and with rapidl recovery(101+/-56.4 mins). 3) Meperidine with diazepam was associated with the lowest score of pain sensation(1.4+/-0.69), but had prolonged recovery time(206+/-126 mins) twice that of other techniques. It was conclued that the combination A thiopental sodium and meperidine was the technique of choice for termination of pregnancy as day-cases.
Anesthesia ; Diazepam ; Humans ; Meperidine ; Pregnancy* ; Thiopental

BACKGROUND: Mivacurium has a considerably shorter duration of action than any other currently used nondepolarizing agent. Rocuronium, on the other hand, has a brief onset but an intermediate duration of action. The current study was undertaken to characterize the interaction between mivacurium and rocuronium in rabbits. METHODS: In the first study, the dose-response relations of mivacurium, rocuronium and their combination were studied in thirty rabbits during thiopental anesthesia. Rabbits, randomly assigned to three groups (n=10), received mivacurium 10, 20, or 30 microgram/kg; rocuronium 50, 70, or 90 microgram/kg; or an equieffective combination of both drugs (0.3 ED50 mivacurium 0.3 ED50 rocuronium; 0.5 ED50 mivacurium 0.5 ED50 rocuronium; or 0.7 ED50 mivacurium 0.7 ED50 rocuronium, where ED50 is the dose producing 50% depression of the twitch height). In the second study, twenty rabbits were randomly allocated to two groups (n=10) to receive mivacurium 0.18 mg/kg or rocuronium 0.6 mg/kg. When the twitch height recovered to 25%, each rabbit received mivacurium 16.4 microgram/kg. RESULTS: The calculated ED95 and ED50 for mivacurium were 29.1 4.2 (mean SD) and 16.4 3.3 microgram/kg, respectively. Corresponding rocuronium was 95.1 6.7 and 61.5 5.3 microgram/kg, respectively. The interaction between mivacurium and rocuronium was found to be synergistic. The measured ED50 of the mixture was only 54% of the predicted value assuming a purely additive interaction. In the second study, the times after mivacurium until 95% in mivacurium and rocuronium group were 18.1 4.6 min and 37.7 5.7 min, respectively (p<0.0001). CONCLUSIONS: The combination of mivacurium and rocuronium is synergistic interaction and after rocuronium induced neuromuscular block, mivacurium becomes a longer acting agent than the shorter agent.
Anesthesia ; Depression ; Hand ; Neuromuscular Blockade ; Rabbits* ; Thiopental