Administration Of Thiopental Research Articles

Sedative and hypnotic effects with cortical EEG sleep-wake profiles of Millingtonia hortensis dried flower aqueous in mice

The ethnopharmacological relevance of the Millingtonia hortensis (M. hortensis) flower's aqueous extract lies in its traditional use as a herbal remedy in Southeast Asia. With a rich history in folk medicine, this aqueous has been esteemed for its purported sedative and anxiolytic properties. Our research delves into the scientific basis of these traditional claims, exploring the potential mechanisms underlying the observed effects of M. hortensis flower's aqueous extract on sleep promotion and mood regulation. This study aimed to explore the sleep-promoting effects of M. hortensis dried flower in mice, using an aqueous concentration equivalent to a human concentration of 2.7 mg/mL. Anxiolytic and antidepressant properties were evaluated using behavioural tests, while electroencephalography (EEG) analysis probed the neural mechanisms underlying sleep promotion post-consumption. The aqueous extract of M. hortensis dried flower administered to mice showed a decrease in immobility in the forced swimming test, demonstrating antidepressant-like effects. Moreover, mice treated with M. hortensis aqueous exhibited increased non-rapid eye movement (NREM) sleep duration, corroborating sleep-promoting potential. EEG analysis of mice treated with M. hortensis aqueous revealed heightened beta oscillations in the frontal and parietal cortex, while pre-treatment with M. hortensis aqueous or diazepam enhanced rapid eye movement (REM) sleep after thiopental administration. Interestingly, M. hortensis aqueous pre-treatment augmented delta frequency ranges in the frontal cortex. Overall, these findings indicate that M. hortensis dried flower's aqueous extract, at a human-equivalent dosage, exerts significant behavioural and neural effects specifically, sedative and hypnotic aspects in mice, corroborating its potential as a natural remedy to promote sleep and regulate mood.

In vivo study of the utility of selective intra-arterial injection of thiopental for neuroprotection in reversible cerebral ischemia.

Neuroprotective agents are needed to reduce cerebral damage during surgical or neurointerventional procedures including stroke patients. To evaluate if thiopental can be used as a neuroprotective agent when injected intra-arterially in a transient ischemia model. In total, 24 rabbits were studied as four groups of six animals. Group 1 served as the control group. In group 2, transient ischemia was obtained by intracarotid administration of degradable starch microspheres (DSM). Group 3 was administered thiopental intra-arterially via the carotid artery. Group 4 (experimental group) received both thiopental and DSM intra-arterially. DSM and thiopental were administered through a microcatheter placed into the common carotid artery via the central ear artery access. After sacrifice, apoptotic cells in the cerebral tissues of the animals were evaluated in H&E and TUNEL stained slides. There was a significant increase in the number of apoptotic glial or neuronal cells in group 2 compared to the control group and group 3. The mean number of both the apoptotic neuronal cells (6.8 ± 2.1 vs. 2.5 ± 1.3, P < 0.001) and the apoptotic glial cells (9.4 ± 3.1 vs. 4.6 ± 1.6, P < 0.001) were higher in group 2 compared to group 4. In addition, a higher level of neurological improvement was observed in group 4 compared to group 2 based on neurological assessment score. The intra-arterial administration of thiopental has a protective effect on both glial and neuronal cells during temporary cerebral ischemia in low doses.

Study of the effect of external use of a brown algae product on the structural-functional continuum

The authors, in a study on 25 outbred Wistar white rats weighing 180-200 g, determined the effect of Lamidana (a product from sea brown algae) on the structural-functional continuum, that is, the correlation of the functional activity of the liver parenchyma and its structural characteristics. Methods. The detoxifying function of the liver was studied by the duration of sleep of animals due to the action of anesthesia - intraperitoneal administration of sodium thiopental (estimate the rate of metabolism of thiopental, carried out by the cytochrome-P-450-dependent monooxygenase system of hepatocytes). The structural and functional state of the liver parenchyma was assessed according to the study of histological preparations. The results of the studies showed that under the influence of the external application of "Lamidin" in the test rats, the liver1s detoxification function is enhanced (significantly significant decrease in the duration of sleep of animals). At the same time, structural signs of increased functional activity of hepatocytes are determined in the parenchyma. Conclusions. The authors believe that "Lamidan", due to the peculiarities of its chemical composition, enhances the metabolic and functional activity of hepatocytes but does not damage the correlative relationships between the structure and function of hepatocytes.

Sedation Therapy in Intensive Care Units: Harnessing the Power of Antioxidants to Combat Oxidative Stress.

In critically ill patients requiring intensive care, increased oxidative stress plays an important role in pathogenesis. Sedatives are widely used for sedation in many of these patients. Some sedatives are known antioxidants. However, no studies have evaluated the direct scavenging activity of various sedative agents on different free radicals. This study aimed to determine whether common sedatives (propofol, thiopental, and dexmedetomidine (DEX)) have direct free radical scavenging activity against various free radicals using in vitro electron spin resonance. Superoxide, hydroxyl radical, singlet oxygen, and nitric oxide (NO) direct scavenging activities were measured. All sedatives scavenged different types of free radicals. DEX, a new sedative, also scavenged hydroxyl radicals. Thiopental scavenged all types of free radicals, including NO, whereas propofol did not scavenge superoxide radicals. In this retrospective analysis, we observed changes in oxidative antioxidant markers following the administration of thiopental in patients with severe head trauma. We identified the direct radical-scavenging activity of various sedatives used in clinical settings. Furthermore, we reported a representative case of traumatic brain injury wherein thiopental administration dramatically affected oxidative-stress-related biomarkers. This study suggests that, in the future, sedatives containing thiopental may be redeveloped as an antioxidant therapy through further clinical research.

Decompressive craniectomy as a second/third-tier intervention in traumatic brain injury: A multicenter observational study

ObjectivesRESCUEicp studied decompressive craniectomy (DC) applied as third-tier option in severe traumatic brain injury (TBI) patients in a randomized controlled setting and demonstrated a decrease in mortality with similar rates of favorable outcome in the DC group compared to the medical management group. In many centers, DC is being used in combination with other second/third-tier therapies. The aim of the present study is to investigate outcomes from DC in a prospective non-RCT context. MethodsThis is a prospective observational study of 2 patient cohorts: one from the University Hospitals Leuven (2008–2016) and one from the Brain-IT study, a European multicenter database (2003–2005). In thirty-seven patients with refractory elevated intracranial pressure who underwent DC as a second/third-tier intervention, patient, injury and management variables including physiological monitoring data and administration of thiopental were analysed, as well as Extended Glasgow Outcome score (GOSE) at 6 months. ResultsIn the current cohorts, patients were older than in the surgical RESCUEicp cohort (mean 39.6 vs. 32.3; p < 0.001), had higher Glasgow Motor Score on admission (GMS < 3 in 24.3% vs. 53.0%; p = 0.003) and 37.8% received thiopental (vs. 9.4%; p < 0.001). Other variables were not significantly different. GOSE distribution was: death 24.3%; vegetative 2.7%; lower severe disability 10.8%; upper severe disability 13.5%; lower moderate disability 5.4%; upper moderate disability 2.7%, lower good recovery 35.1%; and upper good recovery 5.4%. The outcome was unfavorable in 51.4% and favorable in 48.6%, as opposed to 72.6% and 27.4% respectively in RESCUEicp (p = 0.02). ConclusionOutcomes in DC patients from two prospective cohorts reflecting everyday practice were better than in RESCUEicp surgical patients. Mortality was similar, but fewer patients remained vegetative or severely disabled and more patients had a good recovery. Although patients were older and injury severity was lower, a potential partial explanation may be in the pragmatic use of DC in combination with other second/third-tier therapies in real-life cohorts. The findings underscore that DC maintains an important role in managing severe TBI.

ОСОБЕННОСТИ ФОРМИРОВАНИЯ НЕСПЕЦИФИЧЕСКИХ ПАТОМОРФОЛОГИЧЕСКИХ ИЗМЕНЕНИЙ В ТКАНИ ПОЧЕК ПРИ ОПУХОЛЕВЫХ ПРОЦЕССАХ (ЭКСПЕРИМЕНТАЛЬНОЕ ИССЛЕДОВАНИЕ)

The study is relevant due to an increase of oncological diseases and its complications from tumor growth or treatment. Research purpose : to study in an experiment the formation of pathomorphological changes in kidney tissue, taking into account the development of the tumor process and cytostatic therapy. Research objectives : to study morphological changes in the kidneys caused by the tumor process in an animal experiment; to study the effect of methotrexate on the dynamics of pathomorphological changes in the kidneys; to identify of the severity of pathomorphological changes in experimental groups. Materials and methods . We conduct the study on Balb/c mice according to the recommendations set out by the Ministry of Health of the USSR no. 755 and the Helsinki Declaration. Euthanasia was performed by administration of sodium thiopental. The control group was represented by mice without formed tumors. Experimental groups were formed from animals with tumors. Pathomorphological changes in the kidneys were studied both without the administration of methotrexate and with the use of methotrexate. Cytostatic was administered in a dosage of 0.2 mg. Pathomorphological studies of tumors and kidneys were carried out according to the standard histological technique. Results . In experimental groups of animals with a tumor process, nonspecific pathomorphological changes prevailed in the form of irreversible necrobiotic and microcirculatory changes in both cortical and cerebral sections of nephrons, while fibroplastic and microcirculatory changes prevailed when methotrexate was administered. Conclusion . The severity of pathomorphological changes in the kidneys depended on the presence of a tumor process and the effects of methotrexate.

DYNAMICS OF PATHOMORPHOLOGICAL CHANGES OF THE MYOCARDIUM IN CHRONIC EXPERIMENTAL ENDOTOXICOSIS

Relevance. Modeling the conditions of endotoxicosis by introducing bacterial lipopolysaccharide against the background of toxic liver damage is due to the fact that under such conditions the situation that accompanies almost every chronic pathology, including cardiovascular, is reproduced. The release of substances that play a role in the formation of endogenous intoxication causes heart damage in the absence of cardiac pathology, and in its presence worsens the course and prognosis. However, it should be found out whether these changes are the result of only toxic damage to cardiomyocytes or have another morphological basis and what their dynamics are.&#x0D; Objective: to characterize the morphological changes of the myocardium in experimental chronic endotoxicosis.&#x0D; Materials and methods. The research was carried out by modeling endotoxicosis in 18 laboratory animals for 90 days by daily intragastric injection of tetrachloromethane at the rate of 3-5 ml/kg of body weight and every 6th day by intraperitoneally adding bacterial lipopolysaccharide at a dose of 0.2 mg/kg of body weight. Animals were removed from the experiment by decapitation at 30, 60, and 90 days. Animals were removed from the experiment by decapitation after anesthesia with intraperitoneal administration of sodium thiopental at a dose of 50 mg/kg. The control group consisted of 6 intact animals. For histological examination, myocardial tissue was condensed in paraffin, and deparaffinized sections were stained with hematoxylin and eosin, examined for the detection of neutral glycosaminoglycans and acidic mucopolysaccharides, stained with Alcian blue and PAS-reaction according to standard methods, and examined under a Nikon Eclipse Ci-E light microscope.&#x0D; Results. During researching the myocardium at the light-optical level of experimental animals, after 30 days of chronic endogenous intoxication caused by injection of tetrachloromethane and bacterial LPS, it undergoes changes, first of all, it concerned cardiomyocytes: we observe thinned cells around the vessels and unchanged ones at a distance from the vessels. In some of them, hyperchromia of the nuclei and phenomena of contractile damage and fiber fragmentation were noted. Manifestations from the CMC increased during the next period of the experiment: after 60 days, expressed wave-like deformation of fibers with atrophic changes in muscle cells was detected in the myocardium. Hemodynamic changes were characterized by hyperemia, the number of perivascular hemorrhages increased. On the 90th day of the experiment, in addition to inflammatory manifestations and dystrophic-necrotic changes, cardiomyocyte atrophy in combination with expressed interstitial edema was detected in the myocardial tissue of animals. In the stroma, in addition to small foci of perivascular cardiosclerosis, foci of adipocyte growth were determined. Cardiomyocyte defibrillation and hemorrhages were observed in some areas&#x0D; Conclusion. The intensity of structural changes in cardiomyocytes and hemodynamic disorders in chronic endotoxicosis depends on the duration of intoxication and the character of structural changes. The interstitium of the myocardium of rats under experimental endotoxicosis conditions is dystrophic-sclerotic and is manifested by a different combination of edematous and sclerotic manifestations at different stages of exposure to toxicants.

Disorders in the Functional State of the Central Nervous System, Intestinal Peristalsis and Microbiocenosis in Experimental Barbiturate Poisoning

Following a single administration of sodium thiopental in high doses (85 mg/kg intraperitoneally), the animals demonstrated the absence or weakening of reflexes at the levels of the spinal cord, medulla oblongata, bridge and midbrain and cerebral cortex over the period of one day. Other signs included a pronounced hypothermia, a decrease in the respiratory rate and a violation of its rhythm, a distinct tendency to bradycardia. On days 1-3 after the administration of sodium thiopental, a restoration of the respiratory rate, heart rate, body temperature, and the functional state of the central nervous system at various levels was observed, with the exception of the cerebral cortex. In the long term, following the administration of sodium thiopental for up to 21 days, a depression of the functional state of the central nervous system at the level of the cerebral cortex, violation of coordinated propulsive peristalsis of the small intestine and intestinal microbiocenosis were detected. Hence, in experimentally simulated barbiturate poisoning, not only is the suppression of the functions of the central nervous system observed, but also significant and prolonged restructuring of the functional state of the gastrointestinal tract.

Histological aspects of rat ovaries supplemented with bee pollen from Cocos nucifera

Bee pollen is a food supplement for its medicinal properties. It has a high concentration of vitamins, mineral salts, proteins, phenolic compounds and carbohydrates, which are beneficial to health. The objective of this work was to evaluate the effects of bee pollen supplementation on the ovarian performance of rats. Fifty pubescent rats were separated into groups maintained with a common feeding routine. Two experimental groups of 15 animals each were supplemented by intragastric administration with 50 mg of bee pollen from Cocos nucifera, for 30 and 90 days. The estrous cycle was followed in the last 12 days of treatment. In the first estrus after treatment, euthanasia was performed by intraperitoneal administration of sodium thiopental (50 mg/kg), to remove the ovaries for making histological sections. The number and types of ovarian structures present were analyzed: secondary follicle, Graafian follicle, atresic follicle and corpus luteum. In animals supplemented for 30 days there was a significant increase in the number of atresic follicles compared to controls. This increase also occurred in the supplemented 90 days compared to 30 days. It was also found a decrease in the number of corpora lutea, suggesting that the effects are time dependent.

Drug Interaction between Dexamethasone and Ketoprofen with Thiopental in Male Dogs: Effect on the Recovery from Anesthesia and Pharmacokinetics Parameters.

Drug-drug interactions (DDIs) are an important part of clinical veterinary pharmacology. Forty-two healthy mixed breed male dogs were randomly divided into three groups. The control group (C) received normal saline (1 mg/kg) 5 minutes before intravenous administration of thiopental (17 mg/kg), the T1 group received ketoprofen (2.2 mg/kg), and the T2 group received dexamethasone (0.2 mg/kg) 5 minutes before thiopental, respectively. Clinical parameters of anesthesia, heart rate, respiration rate, and electrocardiography were measured. Serum samples were also used to assay thiopental concentration using the high-performance liquid chromatography (HPLC) method, and then, thiopental pharmacokinetic parameters were calculated. Changes in the heart rate and respiration were significant intragroup differences 5 and 10 minutes after anesthesia, respectively. Recovery time parameters showed a significant increase between T1 and control groups (P < 0.05). Elimination rate and half-life of thiopental in the T1 group compared to the control and T2 groups showed a significant decrease and increase, respectively. In addition, the distribution of thiopental in T1 showed a significant increase compared to other groups. However, thiopental clearance in T1 and T2 groups had no significant difference with control (P > 0.05). It can be concluded that drug interaction between ketoprofen and thiopental causes to change in the pharmacokinetics parameters and recovery time from anesthesia in comparison with dexamethasone.

Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens

ABSTRACTPurpose:To determine the normal optical nerve sheath (ONS) diameter ultrasonography (ONSUS) and evaluate the possible effects of drugs on ONS diameter during anesthetic induction in healthy pigs.Methods:Healthy piglets were divided into three groups: a control group, that received xylazine and ketamine (X/K); other that received xylazine, ketamine and propofol (X/K/P); and a third group that received xylazine, ketamine, and thiopental (X/K/T). The sheath diameter was assessed by ultrasonography calculating the average of three measurements of each eye from the left and right sides.Results:118 animals were anesthetized (49 X/K 33 X/K/P and 39 X/K/T). Mean ONS sizes on both sides in each group were 0.394 ± 0.048 (X/K), 0.407 ± 0.029 (X/K/P) and 0.378 ± 0.042 cm (X/K/T) (medians of 0.400, 0.405 and 0.389, respectively). The ONS diameter varied from 0.287–0.512 cm (mean of 0.302 ± 0.039 cm). For group X/K, the mean diameter was 0.394 ± 0.048 cm. Significant differences in ONS sizes between the groups P and T (X/K/P > X/K/T, p = 0.003) were found. No statistically significant differences were detected when other groups were compared (X/K = X/K/P, p = 0.302; X/K = X/K/T, p = 0.294).Conclusions:Sedation with thiopental lead to significative ONS diameter reduction in comparison with propofol. ONSUS may be useful to evaluate responses to thiopental administration.

Nephroblastoma cavoatrial tumor thrombus-A challenge to anesthesiologist.

Nephroblastoma cavoatrial tumor thrombus-A challenge to anesthesiologist.

The effect of intravenous administration of propofol, thiopental, or propofol plus thiopental mixture in dogs undergoing experimentally liver insufficiency

The effect of intravenous administration of propofol, thiopental, or propofol plus thiopental mixture in dogs undergoing experimentally liver insufficiency

Features of the structural and functional parameters of the liver in experimental steatohepatitis and its correction in obese rats

The improvement of the pharmacological strategy of non-alcoholic fatty liver disease is based on the study of the effect of pharmaceutical preparations on the structure and function of the liver. The pathogenesis of steatohepatitis is complex and multifactorial, mainly involving genetic, metabolic and environmental factors. The purpose of the study was to characterize the structural and functional parameters of the liver when using the biologically active compound Angiolin for the correction of experimental steatohepatitis. An experimental study was performed on 110 sexually mature white male rats weighing 180-220 grams, which were kept on a standard diet of vivarium. All animals were divided into two groups: control (30 intact animals) and experimental (80 animals). A model of non-alcoholic steatohepatitis was created for all animals of the experimental group. They were kept on a hypercaloric diet with a high fat and high cholesterol content for 8 weeks. After that, part of the animals (10 rats) was withdrawn from the experiment by intrapleural administration of sodium thiopental (50 mg/kg) and the necessary biochemical and morphological studies were performed. Part of the animals (30 rats) was continued to be kept on a high-fat diet for 4 weeks and the biologically active compound Angiolin was administered (20 rats), and Rings-Locke solutions were administered to 10 rats. After the creation of the model, the other animals of the experimental group (40 rats) were transferred to a full-fledged standard semi-synthetic starch-casein diet, and the biologically active compound Angiolin was administered for 20 rats and Ringer-Locke solution for another 20 rats for 4 weeks. Macroscopic evaluation and description of the liver of animals was carried out after withdrawal under thiopental anesthesia. Statistical analysis of the results was carried out using the program “STATISTICA 8” using parametric and non-parametric methods for assessing the results. It was found that the use of the biologically active compound Angiolin once a day for 30 days can reduce cytolysis syndrome (reduce biochemical parameters such as ALT, AST, gamma-glutamyl transpeptidase), reduce cholestasis syndrome (decrease in alkaline phosphatase level), and normalize liver function, improves the morphological state of hepatocytes, which indicates the normalization of the structural and functional state of the liver.

Organometric parameters of the remaining kidney after removal of the contralateral in immature rats

The processes of compensatory hypertrophy of the kidney to the period of puberty are insufficiently studied. Changes in renal parameters after contralateral removal are of scientific interest. The purpose of the study was to establish and compare changes in organometric parameters of the kidney that remained after nephrectomy in non-sexually adult male rats and in sexually mature male rats. Experimental study was performed on 84 non-adult white male rats weighing 53-71 grams, which were kept on a standard vivarium diet. All animals were divided into two groups (42 in each): the first - control, the second - the experimental group. In the control group, the abdominal cavity was opened under ketamine anesthesia, after wich the abdominal wall was sutured in layers. All animals of the experimental group performed surgical intervention - nephrectomy of the left kidney. Animals were withdrawn from the trial by intra-pleural administration of thiopental-sodium 50 mg/kg after 7, 14, 21, 30, 90 days after nephrectomy. Macroscopic evaluation and description of the kidneys of animals was performed after their removal. The statistical analysis of the obtained results was carried out using the “STATISTICA 5.5” program, using parametric and non-parametric methods for evaluating the obtained results. It was found that in the immature rats, the weight of animals in the experimental group (after nephrectomy) was statistically significantly lower in all terms of the observation compared to the control group, and the weight of the kidney of animals in the experimental group, on the contrary, was statistically significantly higher in all terms of observation. The length, width, thickness, volume of kidneys of animals of the experimental group, as well as the magnitude of increment of these parameters with each term of observation are determined. The greatest increase in organometric parameters of the kidney was observed after 30 days of the postoperative period (p&lt;0.05). Subsequently, on the 60th and 90th day, the magnitude of the increase in organometric parameters of the kidney significantly decreased. The index of hypertrophy of the kidney remained unpaired by nephrectomy, which varied from 52.24% to 63.21%. The highest rates of hypertrophy were observed between the 21st and 30th days.

Delaying initiation of electroconvulsive treatment after administration of the anaesthetic agent and muscle relaxant reduces the necessity of re-stimulation

Objectives: To investigate the effect of delaying initiation of electroconvulsive therapy (ECT) after administration of anaesthetic agent and muscle relaxant.Methods: A retrospective cohort study utilizing a case-based analysis comparing number of re-stimulations, length of seizures, number of ECTs per series and stimulation dosage before and after introducing a new treatment regimen. In 2013, ECT was initiated approximately 60–90 seconds after administration of thiopental and succinylcholine. This interval was increased to 120 seconds in 2014. Ninety-three patients were included (40 in 2013 and 53 in 2014). Outcome measures were length of seizure, number of re-stimulations, number of ECTs per series and stimulation dosage. Regression model analyses were conducted with entering year of treatment (2013 vs. 2014), sex and age as covariates.Results: We showed that a lowered frequency of re-stimulation was independently associated with the 2014 treatment regimen. No effect of treatment regimen on duration of seizures as measured clinically or by EEG, on number of treatments per series or on stimulation dosage was observed.Conclusions: We found an association between an increased time interval from administration of thiopental and succinylcholine to ECT and a lowered risk of re-stimulations. The current study substantially strengthens the evidence on the benefits of delaying ECT after administration of anaesthetic agent and muscle relaxant.

Cortical neurons and networks are dormant but fully responsive during isoelectric brain state.

A continuous isoelectric electroencephalogram reflects an interruption of endogenously-generated activity in cortical networks and systematically results in a complete dissolution of conscious processes. This electro-cerebral inactivity occurs during various brain disorders, including hypothermia, drug intoxication, long-lasting anoxia and brain trauma. It can also be induced in a therapeutic context, following the administration of high doses of barbiturate-derived compounds, to interrupt a hyper-refractory status epilepticus. Although altered sensory responses can be occasionally observed on an isoelectric electroencephalogram, the electrical membrane properties and synaptic responses of individual neurons during this cerebral state remain largely unknown. The aim of the present study was to characterize the intracellular correlates of a barbiturate-induced isoelectric electroencephalogram and to analyse the sensory-evoked synaptic responses that can emerge from a brain deprived of spontaneous electrical activity. We first examined the sensory responsiveness from patients suffering from intractable status epilepticus and treated by administration of thiopental. Multimodal sensory responses could be evoked on the flat electroencephalogram, including visually-evoked potentials that were significantly amplified and delayed, with a high trial-to-trial reproducibility compared to awake healthy subjects. Using an analogous pharmacological procedure to induce prolonged electro-cerebral inactivity in the rat, we could describe its cortical and subcortical intracellular counterparts. Neocortical, hippocampal and thalamo-cortical neurons were all silent during the isoelectric state and displayed a flat membrane potential significantly hyperpolarized compared with spontaneously active control states. Nonetheless, all recorded neurons could fire action potentials in response to intracellularly injected depolarizing current pulses and their specific intrinsic electrophysiological features were preserved. Manipulations of the membrane potential and intracellular injection of chloride in neocortical neurons failed to reveal an augmented synaptic inhibition during the isoelectric condition. Consistent with the sensory responses recorded from comatose patients, large and highly reproducible somatosensory-evoked potentials could be generated on the inactive electrocorticogram in rats. Intracellular recordings revealed that the underlying neocortical pyramidal cells responded to sensory stimuli by complex synaptic potentials able to trigger action potentials. As in patients, sensory responses in the isoelectric state were delayed compared to control responses and exhibited an elevated reliability during repeated stimuli. Our findings demonstrate that during prolonged isoelectric brain state neurons and synaptic networks are dormant rather than excessively inhibited, conserving their intrinsic properties and their ability to integrate and propagate environmental stimuli.

RSII rapid-sequence induction of anaesthesia and intubation of the trachea

Rapid sequence induction and intubation (RSII) is the preferred method of tracheal intubation in emergen­cy situations for patients presenting with a full stomach. The aim of RSII is to intubate the trachea within 60 seconds, without having to use bag-valve-mask ventilation to avoid air insufflation into the stomach. After preoxygenation and while cricoid pressure is applied, an induction dose of intravenous anaesthetic agent is administered and rapidly followed by a fast-acting muscle relaxant, and after 60 seconds tracheal intubation is performed. Preoxygention increases apnoea tolerance. This is particularly important for infants and young children, and in patients who are in critical condition, obese or pregnant. Cricoid pressure (the Sellick manouver) is recommended to prevent regurgitation of the gastric contents to the throat. Propofol or thiopental are routinely used for induction. Ketamine or etomidate may be used if propofol or thiopental administration is contraindicated. Succinylcholine or rocuronium are used to facilitate tracheal intubation. Poor jaw relaxation, patient resistance to a laryngoscope, closed or closing vocal cords, vigorous limb movements or sustained coughing after tube insertion are not clinically acceptable. Modified rapid sequence induction, used in patients at risk of rapid development of hypoxaemia, allows gentle positive pressure ventilation after administration of the induction agent and muscle relaxant, but before the tracheal intubation. If the attempt of intubation fails, sugammadex, 16 mg/kg body weight is recommended for the immediate reversal of the neuromuscular block produced by rocuronium, but not for other muscle relaxants.

Efficacy and safety of intravenous thiopental for sedation during magnetic resonance imaging in pediatric patients: A retrospective analysis.

Introduction:Although the administration of rectal thiopental for sedation during magnetic resonance imaging (MRI) has been well described, there are limited data regarding its intravenous (IV) use in this clinical scenario. The aim of this study was to investigate the efficiency of IV thiopental for sedation during MRI in the pediatric population.Methods:A retrospective review was conducted over a 12-month period of pediatric patients who received IV thiopental for sedation during MRI. Data collected included the procedure length, the induction dose, the time to sedation, recovery time, total sedation time, and adverse events. The parents were telephoned and questioned regarding any adverse effect after discharge and their satisfaction (yes = satisfied; no = not satisfied) regarding the sedation process.Results:A total of 300 (American Society of Anesthesiology I–II status) pediatric patients received IV thiopental for sedation during MRI. The average age of the patients was 4.7 ± 3 years. Thiopental was administered as an initial IV bolus dose of 3 mg/kg, followed by additional bolus doses of thiopental (1 mg/kg) as needed to achieve a Ramsay sedation score of 4. The average procedure length was 20.7 ± 11.9 min. The average total dose of thiopental during the procedure was 5.6 ± 0.9 mg/kg. Patients recovered in an average time of 11 ± 5.6 min after a total sedation time of 31.7 ± 14.2 min. None of the patients had oxygen desaturation, adverse effects before or after discharge, and no patient required unplanned hospital admission. All parents were satisfied with the sedation process.Conclusion:IV thiopental is an effective, safe, and inexpensive medication for the sedation of children undergoing MRI.

STUDY OF THE COMBINED INFLUENCE OF SODIUM THIOPENTAL AND DELTA SLEEP-INDUCING PEPTIDE ON ANTIOXIDANT DEFENSE SYSTEM IN RATS

A biochemical investigation was performed into activity of rat antioxidant defense enzymes at different time interval after administration of sodium thiopental and delta-sleep-inducing peptide (DSIP). It was shown that thiopental coma was accompanied by a decreased level of superoxide dismutase ( 6 and 24 h after exposure) and increased level of caspase-3 ( 6 h after exposure) in the rat blood plasma. A pharmacological correction with DSIP induced a decrease of the level of superoxide dismutase ( 6 and 24 h after exposure), glutathione peroxidase and glucose 6-phosphate dehydrogenase (after 6h).