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*

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

In a randomized study of 16 pediatric patients undergone open-heart surgery, the postoperative recovery time and ventilatory support time of the patients anesthetized with fentany (fentanyl group, n=8) was compared with those of the patients anesthetized with morphine (morphine group, n=8). All patients were premedicated with 0.1 mg/kg of morphine and 0.008mg/kg of glycoppyrolate i.m. 1hr prior to anesthesia. In morphine group, anesthesia was induced with morphine 0.5mg/kg and thiopental 3 mg/kg and in fentanyl group with fentanyl 5 ug/kg and thiopental 3 mg/kg. Anesthesia was maintained with assigned opiate based upon cardiovascular signs. The total doses of opiates are 3.2mg/kg in morphine group and 34.3pg/kg in fentanyl group. In fentanyl group the time to regain consciousness (107+/-53min), ventilatory support time (209+/-53min) and the time from end of operation to extubation (589+/-82min) are significantly shorter than in morphine group (142+/-41min, 838+/-220min, 1470+/-269min, respectively). From the above results fentanyl is more suitable i.v. anesthetic agent for open-heart surgry in respect of postoperative ventilatory care.
Anesthesia ; Consciousness ; Fentanyl* ; Heart* ; Humans ; Morphine* ; 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

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

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

BACKGROUND: An automatic procedure to detect and recognize the specified drugs for a target controlled infusion system based on the absorption ratio of the optical signals (red and infrard light) was proposed. METHODS: A red (660 nm) and infrared (925 nm) light emitting diode (R-IR LED) and photodiode was established at two perforated holes on a 50 ml syringe horizontally and opposite. The syringe was isolated from extra-light sources, such as sun-light or fluorescent light, with a dark sheet. First, the light of the R-IR LED was emitted into free space without insertion of any other syringe. After measuring the intensity of radiation, a 30 ml syringe containing a drug solution was pushed into the 50 ml syringe and again the intensity of light was measured. We measured intensities of light for 1% or 2% propofol and 0.5% thiopental sodium three times and compared it to the measurement of the free space. In order to investigate mechanical error, we measured it again two days later. We calculated errors among each measurement, simple errors and ratios between first and second time measurements and whether the error was within a permissible error range (less than 1%). After all of this, we evaluated the accuracy and clinical usefulness of this new method. RESULTS: Ratio of intensities of transmission of light in each drug solution to free space showed thiopental, 1% propofol and 2% propofol in order. Considering permissible error between the first and second time measurements, this method showed no problem in recognition of kinds and concentrations of drugs. CONCLUSIONS: We supposed that this simple optical method for drug recognition can be applied for target controlled infusion operation instead of the currently available magnetic recognition tag combined to a syringe.
Absorption ; Anesthetics, Intravenous* ; Propofol ; Syringes ; Thiopental

BACKGROUND: Rocuronium has a high incidence of vascular pain when injected intravenous by, and diverse methods have been examined to reduced this pain. The aim of this study was to evaluate the effect of ketamine pretreatment on vascular pain during the injection of rocuronium in pediatric patients. METHODS: Sixty ASA physical status 1 patients scheduled for elective surgery were randomly divided into three groups; a control group (placebo: normal saline, n = 20), group 1 (ketamine 0.5 mg/kg pretreatment, n = 20), and group 2 (ketamine 1 mg/kg pretreatment, n = 20). The ketamine pretreatment was injected in the preanesthetic room. After being moved into the operation room, general anesthesia was induced using thiopental sodium 5 mg/kg in control group. All groups were followed during and after injecting rocuronium 0.9 mg/kg IV. Vascular pain was graded using a 4-point scale. RESULTS: The incidence of vascular pain diminished significantly in the ketamine pretreated group, as follows: 17 (85%) in control group, 4 (20%) in group 1 and 7 (35%) in group 2. CONCLUSIONS: Intravenous ketamine pretreatment at 0.5-1 mg/kg may effectively reduce or prevent vascular pain on injecting rocuronium in pediatric patients.
Anesthesia, General ; Humans ; Incidence ; Ketamine* ; 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*