Thiopental Group Research Articles

The effect of propofol versus thiopentone on APGAR score of babies delivered and recovery of pregnant mothers undergoing elective cesarean section

Background and objectives: The Apgar score is a vital indicator of the baby's well-being. This study aims to compare the effects of propofol and thiopental anesthetics on babies' Apgar scores and mothers' recovery times, this study was carried out. Methods: This single-arm interventional study was conducted in Zhyan and Soma Hospital in Sulaimani, Kurdistan Region of Iraq from February 2022 to July 2022. Separate doses of propofol and thiopental were given to 140 pregnant women who were candidates for elective cesarean section in two separate groups. Apgar scores at 1 and 5 minutes after birth, recovery time, and hemodynamic changes before and after the intervention were evaluated and compared. Results: The results of the diastolic pressure variable after the intervention and the hemodynamic variables were significantly different in each group before and after the intervention (P<0.001). The mean recovery time in propofol and thiopental groups was 21.4 ± 2.4 and 26.0 ± 1.8 minutes, respectively, and they were statistically significantly different (p<0.001). There was a statistically significant difference in the Apgar score at the 5th minute between the two groups (p=0.03). In terms of the need for resuscitation after the first minute, the results were in favor of the propofol group (p<0.001). Conclusion: Propofol can be used more safely since patients who had anesthesia with it had better hemodynamics, quicker recovery times, neonates with higher Apgar scores, and less need for postpartum resuscitation.

Comparison of Low and High Doses of Pentobarbital or Thiopental for Euthanasia of Isoflurane-anesthetized Pigs.

Barbiturate overdose is a common method for euthanizing pigs. However, barbiturates can cause tissue damage and may affect experimental results, so the minimal dose should be used. The minimal dose of barbiturate for euthanasia in pigs under isoflurane anesthesia has not yet been determined. In this study, we compared the effect of low and high doses of 2 barbiturates (pentobarbital, 30 or 60 mg/kg; thiopental, 20 and 40 mg/kg) on hemodynamic parameters and time to cardiac arrest in female pigs maintained on isoflurane. Acute decreases in blood pressure and end-tidal CO₂ occurred in all pigs shortly after administration of the barbiturate. However, these changes were not different between either of the high- and low dose groups. Cardiac arrest occurred significantly faster for high dose as compared with low dose thiopental groups, but this parameter was different between the 2 pentobarbital groups. The bispectral index fell immediately after dosing, in all pigs, but no significant differences were observed in the time needed to achieve 0 for the high or low-doses of either drug. In pigs maintained on isoflurane, a low dose of barbiturates is adequate for euthanasia and may result in less tissue damage.

The effects of thiopental on cold ischemic injury in renal transplantation

One of the most important factors influencing post-transplant success in kidney transplantation is preserving the viability of the organ from removal to transfer into the recipient. This study aimed to reduce the energy requirement with thiopental doses administered before organ transplantation, and to increase the organ viability by minimizing the tissue damage during the cold ischemia process. Twenty female Wistar albino rats were divided into two groups: control group (group C), and thiopental group (group T). In group C, a midline incision was performed, and the renal artery was isolated under ketamine and xylazine anesthesia. A standard organ storage solution (cooled to +4°C) was used for kidney perfusion. Nephrectomy was applied, and the removed kidneys were placed into +4°C standard organ storage solution and stored at +4°C for 12 hours. Animals in group T were subjected to the procedures explained above under 85mg/kg thiopental sodium anesthesia. After 12-hour storage, samples from the kidney tissues were fixed in 10% neutral buffered formalin. Histopathological evaluation and apoptosis detection via TUNEL method were performed. Tubular necrosis was more extensive in group C compared with that in group T and this difference was statistically significant. Similarly, vacuolization was widely observed in group C, and this increase was also statistically significant. For the 'dilatation of Bowman's space' parameter, a significant decrease was observed in group T compared with group C. When the apoptotic index values of both groups were examined, it was seen that they were lower in group T than those in group C. This result was statistically significant. These data suggest that thiopental provides protection to the kidney tissue during the cold storage process. Thiopental has been shown to decrease the number of apoptotic cells in the kidney tissue when administered to the donor before organ transplantation, increasing the organ viability.

Differences in Cognitive Adverse Effects and Seizure Parameters Between Thiopental and Propofol Anesthesia for Electroconvulsive Therapy.

Electroconvulsive therapy (ECT) is a well-established treatment option in case of severe and treatment-resistant psychiatric conditions. In this retrospective study, we compared the 2 anesthetics propofol and thiopental in terms of seizure quality, cognitive adverse effects, and clinical outcome. Data collection was performed retrospectively by a chart review, including patient files and medical records. A total of 64 patients (female = 60.9%) treated with ECT within the period of February 2019 to March 2020 were included. Of these, 35 (54.7%) received thiopental for ECT narcosis and 29 (45.3%) were treated with propofol. Six hundred sixteen ECT treatments (mean number per case, 9.6) were performed in total. The mean electroencephalogram seizure duration (38.3 vs 28.1 seconds, t = 3.534, degrees of freedom [ df ] = 62, P < 0.001) and motor seizure duration (21.5 vs 12.0, t = 4.336, df = 62, P < 0.001) as well as postictal suppression index and heart rate increase were significantly higher in the thiopental group. Mean stimulation energy needed per session was higher in the propofol group (88.6% vs 73.0%, Mann-Whitney U test, P = 0.042). The ECT series was more likely to be interrupted due to cognitive adverse effects in the thiopental group ( P = 0.001, Pearson χ 2 = 10.514, df = 1). Number of patients achieving remission was significantly higher in the thiopental group (31.4% vs 6.9%, P = 0.015, χ 2 = 5.897, df = 1). Thiopental led to better seizure duration and quality and was associated with a higher rate of remission. As a downside, thiopental was also associated with a greater risk of cognitive adverse effects.

Comparison of cerebral effects of thiopental and propofol infusion in traumatic brain injured rats

Aim: Head trauma is a lethal, disabling, and pathological condition requiring long-term treatment and care. Thiopental and propofol infusions are frequently used for sedation in the intensive care unit (ICU). However, we do not have clear data on whether they are neuroprotective or neurotoxic. We aimed to compare the early cerebral effects of propofol and thiopental, which are used for sedation in acute head trauma.Methods: A total of 30 rats were included in this experimental study, and the animals were randomly divided into three groups; 5 ml/kg/h 0.9% dose NaCl infusion was given in the control group, 30 mg/kg/h dose propofol infusion was given in the propofol group, and 140 mcg/kg/h dose of thiopental infusion was given in the thiopental group. Blood samples were taken 4 hours after infusion. A craniotomy was performed, the brain was removed, and it was placed in 10% neutral formalin for histological examination. The materials were examined biochemically and histologically and then compared between the groups.Results: The S100B value between the groups was significantly lower in the thiopental group than in the control group (p=0.018). Tau protein levels were significantly lower in the propofol group than in the control group (p=0.07). In histological examinations, the number of apoptotic cells in the propofol and thiopental groups were significantly lower than in the control group (p=0.02). There was no significant difference between the propofol and thiopental groups in apoptotic cell numbers (p=0.3).Conclusion: Our study demonstrated that thiopental and propofol infusions following a head trauma reduced apoptotic cell death and caused a decrease in trauma markers.

Comparing intensity of pain due to intravenous injection of sodium thiopental, propofol, diazepam, and etomidate during induction of general anesthesia.

The aim of the present study was to compare the pain intensity due to intravenous injection of sodium thiopental, propofol, diazepam, and etomidate during the induction of general anesthesia. This was a non-controlled quasi-experimental double-blinded study performed on eligible patients referred to the operating room of Shahid Beheshti Hospital in Yasouj. A total of 200 patients were randomly selected by convenience sampling and based on a table of random numbers generated on a computer. They were then randomly divided into four intervention groups based on random blocks (sodium thiopental, propofol, etomidate, and diazepam). Finally, the collected data were analyzed using descriptive as well as analytical statistical tests such as Chi-square, analysis of covariance (ANCOVA), and Bonferroni post hoc test were analyzed in SPSS ver. 24. The results of the present study showed that the diazepam group experienced the highest pain intensity (8.42) compared to other groups, which was statistically significant (P = 0.001). Also, the sodium thiopental group experienced the highest pain (6.92) after the diazepam group, which was also statistically significant as compared to the other remaining two groups (P = 0.001). Propofol and etomidate groups experienced the lowest pain intensity (3.30 and 3.26, respectively). The present study revealed that the use of diazepam and sodium thiopental as anesthetic drugs was generally associated with greater pain intensity during injection and less hemodynamic stability. The results of the present study indicated that propofol and etomidate are preferred over diazepam and sodium thiopental in abdominal and gastrointestinal surgeries, considering their less pain intensity and fewer hemodynamic changes.

The role of nitric oxide on the antiarrhythmic effects of ketamine/xylazine in a rat model of acute cardiac ischemia-reperfusion.

The prevalence of ventricular arrhythmias during general anesthesia is about 70%. In experimental studies on the antiarrhythmic effects of different agents, using anesthetic drugs that do not have any protective properties are preferable. The present study was conducted to investigate molecular mechanisms involved in the antiarrhythmic effects of ketamine/xylazine (K/X).Sixty male rats were assigned to eight groups: K/X, L -NAME (25–35 mg/kg) with thiopental (TP), L-NAME (25–35 mg/kg) with ketamine/xylazine, L arginine (100 mg/kg) with thiopental, L-arginine (100 mg/kg) with ketamine/xylazine. After anesthetic induction using TP or K/X, the animals were subjected to 30 min of ischemia. Hemodynamic parameters, ventricular arrhythmias during ischemia, the incidence of ventricular tachycardia (VT), and ventricular fibrillation (VF) were measured. Additionally, in order to assess nitrite/nitrate ratio and LDH after ischemia, serum samples were collected and used.Our results showed that in the K/X group, the number of VT and VF, duration of VT (p = 0.006), the severity of arrhythmias (p = 0.0179). There was no VF incidence in this group.These protective effects were faded by administration of L-NAME with K/X. The combination of L- Arginine in the TP group decreased the number and duration of VT (p < 0.001, p = 0.0013) with no incidence of VF in comparison with TP. L-arginine with K/X groups increased the number and duration of VT (p < 0.0001, p < 0.001) compared to K/X and VF was seen (100%). However, there was no significant difference between TP and K/X groups in terms of this nitrite/nitrate ratio. These findings suggest that the antiarrhythmic effects of ketamine/xylazine might be partially relative to the nitric oxide synthesis pathway.

Effects of ketamine, thiopental and their combination on the rat liver: A biochemical evaluation.

In the literature, it has been suggested that ketamine-related oxidative organ damage results from increased blood adrenaline level, and thiopental-related oxidative damage is caused by decreased adrenaline level, suggesting that ketamine-thiopental combination (KT) may be beneficial in reducing the hepatotoxic effect of ketamine. To biochemically investigate the effects of ketamine, thiopental and KT on the liver in rats. Male albino Wistar type rats received intraperitoneally (ip.) 30 mg/kg ketamine in the ketamine alone (KG) group (n = 6), 15 mg/kg thiopental in the thiopental alone (TG) group (n = 6), and 30 mg/kg ketamine + 15 mg/kg thiopental in the ketamine+thiopental (KTG) group (n = 6). The same volume of distilled water as solvent was given to the healthy (HG) animal group. This procedure was repeated once daily for 30 days. At the end of this period, the animals were killed by decapitation and their livers were removed. In liver tissue, malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin-6 (IL-6) levels were measured. The IL-1β, IL-6, TNF-α, adrenalin (ADR), noradrenalin (NDR), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were determined in blood samples taken from the tail veins. In the group treated with ketamine and thiopental alone, MDA, TOS, IL-1β, IL-6, TNF-α, ADR, NDR, ALT, and AST levels were found to be high, and those of tGSH and TAS to be low. However, there was no significant change in the levels of these parameters in the KTG. These results indicate that oxidative stress and inflammation developed in the liver tissue of the group that used ketamine and thiopental alone, suggesting that the KT form may be safer in terms of toxicity in the clinical usage.

Adding a Low Dose of Fentanyl to Propofol in Patients Receiving Electroconvulsive Therapy: A Randomized Controlled Trial

Objective: To evaluate the effects of low-dose fentanyl combined with a reduced dose of propofol on seizure duration and hemodynamic response during electroconvulsive therapy (ECT). Materials and Methods: Twenty-two patients with the American Society of Anesthesiologist Physical Status II to III undergoing ECT were enrolled in the present study. One hundred and five bilateral ECT sessions randomized to receive thiopental 2 mg/kg, propofol 1 mg/kg, and fentanyl 0.3 mcg/kg, followed by propofol 0.5 mg/kg. Succinylcholine 0.5 mg/kg was used for muscle paralysis. Seizure duration, awakening time and hemodynamic changes were compared between groups. Results: One hundred and five bilateral ECT treatments were randomized into thiopental group (n=35), propofol group (n=35), and fentanyl plus propofol group (n=35). The thiopental and fentanyl plus propofol groups had longer EEG and motor seizure durations than the propofol group, but the differences were not statistically significant. There was no difference in stimulus intensity across groups. However, fentanyl plus propofol group had statistically significant prolonged awakening time compare with thiopental group [mean difference 2.71, (95% CI 0.37 to 5.06, p=0.019)] and propofol group (mean difference 2.77, 95% CI 0.42 to 5.12, p=0.016). Only systolic blood pressure in propofol group was significantly lower than thiopental group [mean difference –10.4, (95% CI –19.4 to –1.38, p=0.018)]. There were no significant differences in diastolic blood pressure (df=2, F=2.546, p=0.083), heart rate (df=2, F=0.596, p=0.553), or oxygen saturation across group (df=2, F=2.914, p=0.059). Conclusion: Using a combination of low-dose fentanyl and low-dose propofol during ECT could be beneficial. Further investigation is needed to establish the optimal dose of propofol and fentanyl. Keywords: Electroconvulsive therapy; Fentanyl, Hemodynamic response; Propofol; Thiopental; Seizure duration

Differences in cognitive side-effects and seizure parameters between thiopental and propofol narcosis in ECT

IntroductionThe standard anaesthetic for electroconvulsive therapy (ECT) in our hospital methohexital was no longer available from the beginning of 2019. A change to alternatives became necessary. We initially decided on thiopental and than switched to propofol after the suspicion of increased occurrence of cognitive deficits due to thiopental narcosis was expressed by clinicians.ObjectivesThis retrospective study provides a comparison of the two narcotics in terms of side-effects and seizure parameters.MethodsWe performed a retrospective data collection from our clinical database and identified a total of 64 patients (w=60.9 %, m=39.1 %) got either thiopental (n=35) or propofol (n=29) for ECT narcosis.ResultsThe mean age at the beginning of the ECT series was 56.0 years (20-82, SD 17.8, median 57.5). The groups did not differ in terms of age distribution. On average the depressive episode lastet for 9.0 months (SD 11.5, median 6.0) with no difference between the two groups. The mean EEG seizure time was significantly shorter in the propofol group (28.1 sec; 95%-CI: 23.8-32.4) than in the thiopental group (38.3 sec.; 95%-CI: 34.3-38.3). The mean EMG seizure activity was also shortler in the propofol group (12.0 sec.; 95%-CI: 8.0-15.0) compared with the thiopental group (21.5 sec.; 95%-CI: 18.3-24.8). The ECT series was interrupted due to cognitive side-effects in 20 cases. The majority of these cases (n=17) concerned the thiopental group, compared to 3 cases in the propofol group.ConclusionsPropofol narcosis in ECT was assiosiated with worse seizure parameters, whereas thiopental narcosis was associated with increased risk of cognitive side-effects.DisclosureNo significant relationships.

The Neuroprotective Effect of Thiopental on the Postoperative Neurological Complications in Patients Undergoing Surgical Clipping of Unruptured Intracranial Aneurysm: A Retrospective Analysis.

Although thiopental improved neurological outcomes in several animal studies, there are still insufficient clinical data examining the efficacy of thiopental for patients undergoing surgical clipping of unruptured intracranial aneurysm (UIA). This study validated the effect of thiopental and investigated risk factors associated with postoperative neurological complications in patients undergoing surgical clipping of UIA. In total, 491 patients who underwent aneurysm clipping were included in this retrospective cohort study. Data regarding demographics, aneurysm characteristics, and use of thiopental were collected from electronic medical records. Propensity score matching and logistic regression analysis were used. After propensity score matching, the thiopental group showed a lower incidence of the postoperative neurological complications than non-thiopental group (5.5% vs. 17.1%, p = 0.001). In multivariate analysis, thiopental reduced the risk of postoperative neurological complications (odds ratio (OR) 0.26, 95% confidence interval (CI) 0.13 to 0.51, p < 0.001) while aneurysm size ≥ 10 mm (OR 4.48, 95% CI 1.69 to 11.87, p = 0.003), and hyperlipidemia (OR 2.24, 95% CI 1.16 to 4.32, p = 0.02) increased the risk of postoperative neurological complications. This study showed that thiopental was associated with the lower risk of neurological complications after clipping of UIA.

Effect of General Anesthesia with Thiopental Sodium and Propofol on the 1- and 5 minute Apgar newborns by Cesarean

Background: The Apgar score of newborn babies is a determining factor involved with mortality of newborns after birth. Regarding the disagreement on advantages and possible disadvantages of propofol and thiopental in the available references, the study was triggered with the aim of analyzing effects of two mentioned drugs on babies’ Apgar score. Methods: In this double-blind clinical trial, a total of 100 healthy women who volunteered to undertake cesarean operation were selected and then divided randomly into two equal groups using statistical blocking. One group was treated by propofol while other one was treated by thiopental. The prescribed drugs for both groups were identical. Babies’ Apgar score 1 and 5 minutes after birth and recovery period and some of the critical maternal parameters after operation were recorded. The obtained data were analyzed by SPSS 19 software. Results: Apgar score I minute 1 (p=0.317) and Apgar score in minute 5 (p=1.00) for propofol group were not different meaningfully. The groups had significant differences in the indices such as first systolic (P=0.00) and diastolic (P=0.00) pressure in recovery, last diastolic pressure in recovery (P=0.001) and duration of postoperative recovery (P=0.001). Statistical analysis of nausea and vomit in both groups showed that they are lower in propofol group rather than the thiopental group (p=0.000). Conclusion: Propofol and thiopental did not differ significantly in Apgar score, but it seems that propofol can be a better option to induce anesthesia for an elective cesarean operation.

Thiopental versus ketamine for induction of anesthesia in septic shock: a randomized controlled trial

Background Induction of anesthesia in patients with septic shock might result in deleterious hypotension. The aim of this work is to compare low-dose thiopental versus ketamine for induction of anesthesia in patients with septic shock. Patients and methods In this randomized controlled double-blinded trial, we included 26 patients with septic shock scheduled for emergency operations under general anesthesia. According to the induction protocol, patients were divided into thiopental group (received thiopental 2 mg/kg+fentanyl 0.5 μg/kg+midazolam 0.05 mg/kg), and ketamine group (received ketamine 1 mg/kg+fentanyl 0.5 μg/kg+midazolam 0.05 mg/kg). Both groups were compared according to mean arterial pressure, cardiac output, heart rate, vasopressor requirements, and incidence of postinduction hypotension. Results Both groups were comparable in demographic data. No significant differences were reported between both groups based on mean arterial pressure, cardiac output, and heart rate; however, ketamine group showed higher incidence of postinduction hypotension [11/13 (85%) vs. 5/13 (39%) patients, P=0.041] compared with thiopental group. Conclusion Both study regimens, thiopental-based regimen and ketamine-based regimen, showed equivalent hemodynamic effects when used for induction of anesthesia in patients with septic shock. However, thiopental-based regimen was less likely associated with postinduction hypotension.

Role of Sedative-Hypnotic Agents in Neurodegeneration: Effects of Midazolam and Thiopental on Apoptosis and Oxidative Stress Expression in Neonatal and Adult Rat Brains.

To investigate the effects of midazolam (MDZ) and thiopental on neonatal and adult rat brains. The study included adult and 7-day-old rats that were administered 9 mg/kg of MDZ, 60 mg/kg of thiopental, or both. The Bax, procaspase-3, and caspase-3 levels were assessed using Western Blot analysis and the total oxidative stress index (OSI) values were measured spectrophotometrically. The procaspase-3 and caspase-3 levels were 12% and 6% lower in the neonatal MDZ group when compared to the control group. The Bax, procaspase-3, and caspase-3 levels were higher in the neonatal thiopental group by 25%, 4%, and 34%, and in the MDZ group by 16%, 19%, and 43% when compared to the neonatal control group. In the adult rats, the caspase-3 levels were 10 times higher in the MDZ group when compared to the control and thiopental groups. Moreover, the caspase-3 levels were 7 times higher in the adult thiopental group when compared to the control group. The OSI values in the neonatal rats were significantly higher in the neonatal MDZ and neonatal thiopental groups when compared to the control group (p < 0.05). Similarly, the OSI values in the adult rats were significantly higher in the neonatal MDZ and neonatal thiopental groups when compared to the control group (p < 0.05). MDZ and thiopental may promote apoptosis and oxidative stress, and thereby result in neurotoxicity, with MDZ showing a greater effect in adults and thiopental showing a greater effect in neonates.

The Comparison of Hemodynamic Effect of Propofol and Thiopental During Electroconvulsive Therapy: A Prospective Randomized Controlled Trial

Objective: To compare the hemodynamic effects of propofol with thiopental during electroconvulsive therapy (ECT) in psychiatric patients at the Faculty of Medicine Ramathibodi Hospital. Materials and Methods: Fifteen patients with ASA physical status I-II undergoing 139 ECT sessions participated in this study. Each patient randomly received either propofol or thiopental followed by succinylcholine for muscle relaxation. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR), oxygen saturation (SpO₂), and bispectral index (BIS) were recorded before anesthetic induction, after induction, before seizure, immediately at the end of the seizure, and at post anesthetic care unit (PACU). Results: At two to seven minutes after induction, SBP, and DBP was significantly higher in thiopental group than propofol group after receiving treatments (approximately 11 to 22 mmHg, 6 to 13 mmHg, respectively). The HR was significantly decreased in propofol group at two and three minutes (p=0.002), but not significantly different from PACU (p=0.076). The SpO₂ was not significantly different between the two groups. Propofol significantly decreased electroencephalographic (EEG) and motor seizure duration (p&lt;0.001). Conclusion: Propofol anesthesia provided better hemodynamic responses than thiopental during ECT. Hence, propofol might be a useful alternative to thiopental in patients at higher risk of cardiac complications secondary to marked hemodynamic changes during ECT. However, the duration of seizure in the propofol group was shorter than in the thiopental group. Keywords: Electroconvulsive therapy, Thiopental, Propofol, Bispectral index, Motor seizure

The Effect of Propofol on the Success Rate of Transurethral Lithotripsy by Holmium Laser: A Randomized Clinical Trial.

Introduction: Urinary stone disease is the third most common affliction of the urinary tract that has been associated with an increasing incidence. Over decades, great advances have been made in the minimally invasive treatment of urinary stones. Recently, transurethral lithotripsy (TUL) by holmium laser was introduced as a possible therapeutic option. This study evaluated the effect of propofol on the success rate of TUL by holmium laser. Methods: A double-blind randomized controlled trial was conducted on 180 patients to investigate the effect of propofol on the success and complication rate of TUL by holmium laser. The enrolled patients were divided into two groups: the first group received sodium thiopental (n=89) while the second group received propofol (n=91). The two groups were compared in terms of the fluctuations of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), operation time, future stone-free rate (SFR), stone migration, post-operative fever, and ureteral complications such as perforation and mucosal damage. Other developed complications were also recorded. After data gathering, statistical analysis was performed with SPSS version 21. Results: the patients' data such as age, sex, stone diameter, stone laterality, duration of stone impaction, primary SBP, DBP and HR were not significantly different between the two groups (P>0.05). TUL and anesthesia duration, first-minute and fifth-minute SBP and DBP, and also changes of HR were significantly lower in the propofol group compared with the sodium thiopental group (P <0.001). Moreover, SFR of TUL was more evident in the propofol group. Ureteral mucosal damage was significantly less in the propofol group. Conclusion: Propofol was associated with a higher reduction in SBP and DBP, decreased duration of TUL, fewer fluctuations in HR, and an increased success rate of stone removal by TUL with holmium laser.

Antinociceptive Effect of Intravenous Regional Analgesia in Horses Underwent Selected Short-Time Distal Limb Surgeries

The aim of the present study was to establish appropriate doses for both lidocaine hydrochloride (Hcl) and mepivacaine in intravenous regional analgesia (IVRA) and to assess their intraoperative and postoperative analgesic effects in horses with distal limb surgeries. A total of 55 draft horses were included in the present study. Six clinically healthy horses were selected randomly for establishing the doses of lidocaine Hcl and mepivacaine in IVRA in horse limbs. After selection, 32 horses suffered from various distal limb surgical affections were randomly allocated into three groups: thiopental group (n = 6), animals were operated under general anesthesia using thiopental sodium; IVRA-LID group (n = 12), animals were operated under both general anesthesia and IVRA using lidocaine Hcl; and IVRA-MEP group (n = 14), horses were operated under both general anesthesia and IVRA using mepivacaine. Postoperative pain was measured using both Horse Grimace Pain Scale and multifactorial numerical rating composite pain. The results showed that conjunction of IVRA along with thiopental general anesthesia using either lidocaine or mepivacaine significantly decreased the total required doses of thiopental sodium during the operations and significantly increased the duration of postoperative analgesia to 60 and 150 minutes using lidocaine and mepivacaine, respectively. In conclusion, the uses of local IVRA before distal limb surgery improve the depth of general anesthesia and reduced postoperative pain, despite thiopental anesthesia alone. Mepivacaine is superior to lidocaine in IVRA, with a longer duration of action.

Comparison of electroencephalogram between propofol- and thiopental-induced anesthesia for awareness risk in pregnant women

There have been few comparative studies using electroencephalogram (EEG) spectral characteristics during the induction of general anesthesia for cesarean section. This retrospective study investigated the differences in the depth of anesthesia through EEG analysis between propofol- and thiopental-induced anesthesia. We reviewed data of 42 patients undergoing cesarean section who received either thiopental (5 mg/kg) or propofol (2 mg/kg). EEG data were extracted from the bispectral index (BIS) monitor, and 10-second segments were selected from the following sections: 1) Stage I, BIS below 60 after induction; 2) Stage II, after intubation completion; 3) Stage III, end-tidal sevoflurane above 0 vol%. The risk of awareness was represented by the BIS and entropy measures. In Stage III, the thiopental group (n = 20) showed significantly higher BIS value than the propofol group (n = 22) (67.9 [18.66] vs 44.5 [20.63], respectively, p = 0.002). The thiopental group had decreased slow-delta oscillations and increased beta-oscillations as compared to the propofol group in Stages II and III (p < 0.05). BIS, spectral entropy, and Renyi permutation entropy were also higher in the thiopental group at Stages II and III (p < 0.05). In conclusion, frontal spectral EEG analysis demonstrated that propofol induction maintained a deeper anesthesia than thiopental in pregnant women.

A comparative study of hemodynamic changes and serum cortisol levels of induction agents: Thiopentone, propofol, etomidate

Objective: Haemodynamic changes are inevitable while induction of general anesthesia with anaesthetic drugs. This present study records the haemo­dynamic changes that is caused by three different drugs (thiopental, propofol, and etomidate) used for induction of general anaesthesia. Methods: A Randomized and double-blinded study, 90 patients were assigned to one of the three groups (n=30 each). Propofol- 2 mg kg-1 in Group, Thiopentone- 5 mg kg-1 in Group 2 or Etomidate - 0.3 mg kg-1 in Group 3. Heart rate (HR) Noninvasive measurements of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), was performed on admittance, after giving fentanyl, immediately before the induction of anaesthesia,1,2,3,4,5,6,7,10 mins thereafter intubation. Serum cortisol levels were measured at baseline, after intubation, 30 minutes after induction. Results: Following the administration of propofol (Group 1), a greater decrease of systolic and diastolic blood pressure was observed when compared with that of etomidate (Group 3) or thiopentone (Group 2).Conclusion: In this study, It can be concluded that etomidate is safer than propofol and thiopental groups in terms of haemodynamic stability.

Thiopental versus propofol on the outcome of the newborn after caesarean section: An impact study

In 2011, the company that produced thiopental in France and in the United States stopped its marketing. Because of limited evidences, the choice of the best induction agent for caesarean section remains controversial, especially in emergency. The objective of this study was to compare the effects of propofol versus thiopental on the Apgar score of the newborn. Newborns delivered by elective or emergency caesarean section under general anaesthesia in a university hospital were included from January 2009 to December 2013. Two periods, according to the hypnotic drug used, were compared in this before-and-after comparative study: thiopental before May 2011 and propofol after. The primary outcome was to compare the proportion of newborns with a 5-minute Apgar Score < 7 between both groups. 367 newborns were enrolled, 178 in thiopental group and 189 in propofol group. Demographic and clinical characteristics were similar in both groups. The occurrence of a 5-minute Apgar Score less than 7 was not influenced by the use of propofol (OR 1.40 [CI 95% 0.90-2.20] P = 0.135). Blood gas analyses and admission's rate in neonatal intensive care unit were similar in both groups. Thiopental and propofol do not appear to present significant difference in term of outcome of the newborn after caesarean section. In this situation, propofol may probably be a reliable alternative to the supply reduction of thiopental imposed by forces. Prospective studies are required to confirm the safety of propofol, particularly in the long term.