Thiopentone Group Research Articles

USE OF MIDAZOLAM AS AN INDUCTION AGENT: COMPARISON WITH THIOPENTONE

A prospective, randomized, single-blind investigation was undertaken into the value of midazolam as an agent for the induction of anaesthesia. Sixty patients undergoing orthopaedic surgery of short duration were allocated randomly to receive either midazolam 0.2 mg kg-1 or thiopentone 3 mg kg-1. The induction time (measured as the time until loss of eyelash reflex) in the thiopentone group was significantly shorter than in the midazolam group. No differences were observed between the two drugs as regards time to onset of apnoea, or changes in heart rate and arterial pressure.

Effects of low-dose ketamine and thiopentone on cardiac performance and myocardial oxygen balance in high-risk patients.

Induction of anaesthesia may pose a significant hazard to patients with critical cardiovascular status. Ketamine has been advocated as the drug of choice for maintaining cardiovascular performance during induction of anaesthesia in severely ill surgical patients. The purpose of this study was to compare the relative changes in the haemodynamic effects of ketamine and thiopentone during the first 30 min of anaesthesia induction measured by thoracic impedance cardiography. Twelve adult high-risk surgical patients, ASA class III-V, were induced with thiopentone and fentanyl or with infusion of ketamine. Cardiac output decreased to 69% in the thiopentone group (P less than 0.05), but was hardly affected in the ketamine group. The pre-ejection period to left ventricular time (PEPI) and the pre-ejection period index ratio increased significantly after thiopentone (P less than 0.05), while ketamine caused only minimal changes in left ventricular performance. The diastolic pressure time index to systolic pressure time index ration decreased significantly in both groups.

ALTHESIN AND PANCURONIUM IN CHRONIC LIVER DISEASE

In 32 patients with chronic liver disease, undergoing major abdominal surgery, anaesthesia was induced with either Althesin (alphaxalone and alphadolone acetate) or thiopentone, and maintained with nitrous oxide, oxygen and increments of either pethidine or fentanyl. The patients were ventilated artificially to maintain PaCO, values in the normal range. Pancuronium bromide was used as the muscle relaxant. Liver function tests at 24 hr and 5 day after surgery showed only minor changes compared with findings before operation. There was no significant difference between the Althesin and thiopentone groups. In two patients with severe obstructive jaundice there was difficulty in reversing the effects of pancuronium, but "pancuronium resistance" was observed in all patients. It is concluded that the anaesthetic sequence described, with either Althesin or thiopentone induction, is satisfactory with respect to changes in liver function in patients with chronic liver disease undergoing major surgery.

PROPANIDID VERSUS THIOPENTONE FOR INDUCTION OF GENERAL ANAESTHESIA IN ELECTIVE CAESAREAN SECTION

A comparison was made of the Apgar scores of ninety-four neonates born by elective Caesarean section. Propanidid was used to induce anaesthesia in forty women and thiopentone in fifty-four. Anaesthesia was maintained with nitrous oxide and muscle relaxants. The incidence of neonatal depression was higher in the thiopentone group than in the propanidid group, particularly when induction-delivery time was prolonged more than 10 minutes. This is attributed to the different fates of these drugs: propanidid is rapidly hydrolyzed by esterases, while thiopentone is very slowly metabolized in the liver.

HEART RATE AND ARTERIAL BLOOD PRESSURE DURING DIFFERENT FORMS OF INDUCTION OF ANAESTHESIA IN PATIENTS WITH MITRAL STENOSIS AND CONSTRICTIVE PERICARDITIS

SUMMARY Twenty-four patients about to undergo surgery for mitral stenosis or constxictive pericarditis were studied by recording intra-arterial blood pressure and heart rate continuously during the induction period. In two groups of patients, narcosis was induced with thiopentone or hexobarbitone. In the third group, induction took place with nitrous oxide. The investigation shows that: (1) A significant increase in blood pressure occurred during intubation in all three groups, and was most marked in the thiopentone group. The blood pressure returned to the initial values in the thiopentone and nitrous oxide groups. Pronounced hypotension appeared in the hexobarbitone group. (2) A significant increase in heart rate during intubation occurred only in the barbiturate groups. Bradycardia appeared in the hexobarbitone group.

SERUM ENDOGENOUS THYROXINE LEVELS IN MAN DURING ANAESTHESIA AND SURGERY

SUMMARY Determinations of serum thyroxine concentrations were made before induction of anaesthesia, after 20 minutes and 40 minutes of anaesthesia before operation, during operation, and after the end of operation in 36 patients. After 40 minutes of anaesthesia with diethyl ether and halothane there were significantly increased endogenous serum thyroxine concentrations, but thiopentone, nitrous oxide and oxygen anaesthesia definitely decreased the thyroxine level. Surgical operation further elevated the serum thyroxine level in both ether and halathane anaesthesia groups but no significant rise of thyroxine levels was observed in the thiopentone, nitrous oxide and oxygen groups.

LARYNGEAL MASK AIRWAY PLACEMENT: A COMPARISON BETWEEN PROPOFOL AND THIOPENTONE SODIUM IN THE DAY CASE SURGERY

BACKGROUND: Laryngeal Mask Airway (LMA) placement is now considered a common airway management practice. Although there are many studies which focus on various airway techniques, research regarding difficult LMA placement is limited, particularly for anesthesiologist trainees OBJECTIVE: To assess the effectiveness of Laryngeal Mask Airway (LMA) placement after induction with propofol or thiopentone in one hundred day case urological patients. METHODS: An analytical, non interventional, cross sectional comparative study. Patients were divided into Group A (Propofol Group n=50) received propofol (2.5mg/kg) and Group B (Thiopentone group n=50) received thiopentone sodium (4-6 mg/kg) IV. Management of anaesthesia was identical in both groups. Standard monitoring was including NIBP, pulse oxymetery and ECG was done. Co-induction with done with midazolam 0.1 mg/kg body weight. LMA was inserted after adequate level of anaesthesia and then assessed. The presence of gaging, coughing, laryngospasm and movement were noted , recorded by a colleague anaesthetist who entered the induction room during the two minutes assisted ventilation phase and was not aware of the type of induction agent. Statistical analysis was done by using SPSS version 10. The mean and standard deviation was calculated for age. Frequency of subjects was calculated for gender Lund and stovner assessment scheme. The p value of less than 0.05 was considered significant. RESULTS: Thiopentone was associated with an adverse response in 76% of patients, compared with propofol in 26% (p<0.01). Head movement, Laryngospasm, inadequate jaw relaxation were more common using thiopentone (p<0.05). The quality of anaesthesia according to patients was significantly higher in the propofol group (Group A, 80%) than in thiopentone group (Group B, 30%). CONCLUSION: Adverse responses in Group A were less than Group B. Propofol, therefore is superior to thiopentone as an induction agent for laryngeal mask airway.

SERUM POTASSIUM CHANGES DURING INDUCTION OF ANAESTHESIA

SUMMARY Serum potassium levels of 53 patients before and after induction with halothane and oxygen, halothane, nitrous oxide and oxygen, and thiopentone, showed a significant decrease after reaching the first surgical plane. After the administration of the depolarizing agent suxamethonium serum potassium levels increased significantly more in the two halothane groups than in the thiopentone group. It is thought that both halothane and thiopentone reduce the number of depolarizations, whereas suxamethonium causes an acute increase in the number of depolarizations. Other factors that could influence serum potassium, such as decrease or increase in blood sugar, alkalosis or acidosis, were also investigated. It is concluded that they did not play a significant role in the measured potassium changes.