thiopental and barbituric-acid

The aim was to study the effects of barbiturate coma treatment (BCT) on intracranial pressure (ICP) and intracranial compensatory reserve (RAP index) in children (< 17 years of age) with traumatic brain injury (TBI) and refractory intracranial hypertension (RICH).. High-resolution monitoring data were used to study the effects of BCT on ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and RAP index. Four half hour long periods were studied: before bolus injection and at 5, 10, and 24 hours thereafter, respectively, and a fifth tapering period with S-thiopental between < 100 and < 30 μmol/L. S-thiopental concentrations and administered doses were registered.. Seventeen children treated with BCT 2007-2017 with high-resolution data were included; median age 15 (range 6-17) and median Glasgow coma score 7 (range 3-8). Median time from trauma to start of BCT was 44.5 h (range 2.5-197.5) and from start to stop 99.0 h (range 21.0-329.0). Median ICP was 22 (IQR 20-25) in the half hour period before onset of BCT and 16 (IQR 11-20) in the half hour period 5 h later (p = 0.011). The corresponding figures for CPP were 65 (IQR 62-71) and 63 (57-71) (p > 0.05). The RAP index was in the half hour period before onset of BCT 0.6 (IQR 0.1-0.7), in the half hour period 5 h later 0.3 (IQR 0.1-0.7) (p = 0.331), and in the whole BCT period 0.3 (IQR 0.2-0.4) (p = 0.004). Eighty-two percent (14/17) had favorable outcome (good recovery = 8 patients and moderate disability = 6 patients).. BCT significantly reduced ICP and RAP index with preserved CPP. BCT should be considered in case of RICH.

Topics: Adolescent; Anticonvulsants; Arterial Pressure; Barbiturates; Brain Injuries, Traumatic; Cerebrovascular Circulation; Child; Coma; Convulsive Therapy; Female; Humans; Intracranial Hypertension; Intracranial Pressure; Male; Retrospective Studies; Thiopental

Spontaneous Ca2+ -oscillations are a possible mechanism of Ca2+ -mediated signal transduction in neurons. They develop by a periodical interplay of Ca2+, which enters the neuron from the extracellular medium and triggers Ca2+ release from the endoplasmic reticulum (ER). Ca2+ -oscillations are terminated by reuptake into the ER or plasmalemmal extrusion. Spontaneous Ca2+ -oscillations are glutamate dependent and appear to be responsible for neuronal plasticity and integration of information. Here, we examined the role of the gamma-aminobutyric acid (GABAA) receptor on spontaneous Ca2+ -oscillations and studied the effects of the anaesthetics midazolam, thiopental and the non-anesthetic barbituric acid on spontaneous Ca2+ -oscillations.. Hippocampal neuronal cell cultures of 19-day-old embryonic Wistar rats 17-18 days in culture were loaded with the Ca2+ -sensitive dye Fura-2AM. Experiments were performed using dual wave-length excitation fluorescence microscopy and calibration constants were obtained from in situ calibration.. Spontaneous Ca2+ -oscillations are influenced by the GABAA receptor. The intravenous anaesthetics midazolam and thiopental suppressed the amplitude and frequency reversibly in a dose-dependent manner with EC50 in clinically relevant concentrations. This effect was mediated via the GABAA receptor as it could be reversed by the GABAA receptor antagonist bicuculline. In contrast, the application of barbituric acid had no effects on the spontaneous Ca2+ -oscillations.. Spontaneous Ca2+ -oscillations are influenced by the GABAA receptor. Spontaneous Ca2+ -oscillations might represent an interesting model system to study anaesthetic mechanisms on neuronal information processing.

Topics: Anesthetics, Intravenous; Animals; Barbiturates; Bicuculline; Calcium; Calcium Signaling; Calibration; Cells, Cultured; Dose-Response Relationship, Drug; Fluorometry; GABA Antagonists; GABA Modulators; gamma-Aminobutyric Acid; Hippocampus; Midazolam; Neurons; Rats; Rats, Wistar; Receptors, GABA-A; Thiopental

We studied whether thiopental affects endothelial nitric oxide dependent vasodilator responses and nitrite production (an indicator of nitric oxide production) elicited by acetylcholine, histamine, and A23187 in rat aorta (artery in which nitric oxide is the main endothelial relaxant factor). In addition, we evaluated the barbiturate effect on nitric oxide synthase (NOS) activity in both rat aorta and kidney homogenates. Thiopental (10-100 microg/mL) reversibly inhibited the endothelium-dependent relaxation elicited by acetylcholine, histamine, and A23187. On the contrary, this anesthetic did not modify the endothelium-independent but cGMP-dependent relaxation elicited by sodium nitroprusside (1 nM - 1 microM) and nitroglycerin (1 nM - 1 microM), thus excluding an effect of thiopental on guanylate cyclase of vascular smooth muscle. Thiopental (100 microg/mL) inhibited both basal (87.8+/-14.3%) and acetylcholine- or A23187-stimulated (78.6+/-3.9 and 39.7+/-5.6%, respectively) production of nitrites in aortic rings. In addition the barbiturate inhibited (100 microg/mL) the NOS (45+/-4 and 42.8+/-9%) in aortic and kidney homogenates, respectively (measured as 14C-labeled citrulline production). In conclusion, thiopental inhibition of endothelium-dependent relaxation and nitrite production in aortic rings strongly suggests an inhibitory effect on NOS. Thiopental inhibition of the NOS provides further support to this contention.

Topics: Acetylcholine; Animals; Aorta, Thoracic; Barbiturates; Calcimycin; Cyclic GMP; Dose-Response Relationship, Drug; Drug Interactions; Endothelium, Vascular; Guanylate Cyclase; Histamine; Kidney; Male; Nitric Oxide; Nitric Oxide Synthase; Nitroglycerin; Nitroprusside; Rats; Rats, Wistar; Thiopental

Topics: Barbiturates; Blood Circulation; Blood Pressure; Iodine Isotopes; Myocardium; Rabbits; Radiometry; Research; Thiopental; Toxicology

Topics: Anesthesia; Barbiturates; Bemegride; Central Nervous System Stimulants; Electrocardiography; Electroencephalography; Fetal Heart; Gynecology; Humans; Pharmacology; Pregnancy; Reflex; Respiration; Surgical Procedures, Operative; Thiopental

Topics: Adrenal Glands; Adrenal Insufficiency; Animals; Barbiturates; Chick Embryo; Chromaffin System; Metabolism; Research; Thiopental; Toxicology

Topics: Alcoholism; Alcohols; Anesthesia; Anesthesia, General; Barbiturates; Drug Tolerance; Ethanol; Ether; Methohexital; Methoxyflurane; Morphine; Rats; Research; Substance-Related Disorders; Thiopental; Toxicology

Topics: Barbiturates; Brain; Central Nervous System; Pharmacology; Physiology; Rats; Research; Sleep; Thiopental

Topics: Amino Acid Oxidoreductases; Amobarbital; Animals; Aspartic Acid; Barbiturates; Chloral Hydrate; D-Aspartic Acid; Enzyme Inhibitors; Ferrocyanides; Metabolism; Mollusca; Oxidoreductases; Pentobarbital; Pharmacology; Phenobarbital; Research; Thiopental; Thiourea; Urea

Topics: Barbiturates; Chemistry, Pharmaceutical; Chromatography; Microchemistry; Research; Thiobarbiturates; Thiopental

Topics: Anesthesia; Anesthesia, Intravenous; Anesthetics, Intravenous; Atropine; Barbiturates; Hexobarbital; Humans; Hypotension; Meperidine; Methohexital; Respiration; Thiopental; Toxicology; Vomiting

Topics: Anesthesia; Anesthesia, General; Anesthesia, Inhalation; Asphyxia Neonatorum; Barbiturates; Cesarean Section; Cyclopropanes; Ether; Female; Humans; Infant Mortality; Infant, Newborn; Muscle Relaxants, Central; Nitrous Oxide; Pregnancy; Thiopental; Toxicology

Topics: Anesthesia; Anesthesia, Intravenous; Animals; Barbiturates; Brain; Caudate Nucleus; Electrophysiology; Rabbits; Research; Thiopental

Topics: Anesthesia; Anesthesia, Obstetrical; Barbiturates; Dystocia; Female; Humans; Labor, Obstetric; Oxytocin; Pregnancy; Thiopental

Topics: Anesthesia; Barbiturates; Humans; Phenobarbital; Porphyrias; Thiopental; Toxicology

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Barbiturates; Electroencephalography; Mesencephalon; Thiopental; Ventral Tegmental Area

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Animals; Barbiturates; Cytochromes; Electron Transport Complex IV; Rats; Thiopental

Topics: Anesthesia; Anesthesiology; Barbiturates; Liver; Thiopental; Transaminases

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Barbiturates; Thiopental

For 24 hr. after intravenous administration of buthalitone or thiopentone, plasma concentrations in young human subjects have been followed. Buthalitone was distributed to the tissues more rapidly but was metabolized at a slower rate than thiopentone. The relationships between these findings and differences in plasma protein binding and oil/water partition coefficients were studied. It is suggested that some of the differences observed in potency between the substances is a reflection of differences in their modes of distribution. No relationship was found between speed of recovery from anaesthesia and plasma barbiturate concentrations.

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Barbiturates; Blood Proteins; Humans; Pain; Pain Management; Protein Binding; Thiopental

Methylethylglutarimide was administered to 488 patients ranging in age from 7 to 89 years, in a study on sleep-reversal after harbiturate anesthesia. Sodium surital or sodium pentothal were the barbiturates used. The drug was administered intravenously in doses varying from 25 to 200 mg. Dosage below 25 mg. was found to be ineffective. Almost all patients showed signs of awakening as evidenced by the return of corneal and conjunctival reflexes, the opening of the eyes, and stirring or moving about. Many responded to questioning. Almost all showed evidence of greater responsiveness within five minutes. No untoward reactions were noted. No convulsions were produced. Five patients ranging in age from 24 to 70 years were treated for barbiturate poisoning with Mikedimide(R) given intravenously in doses varying from 550 mg. to 1950 mg. All recovered consciousness within 30 minutes to an hour. No convulsions were produced. While it is not known whether Mikedimide is a direct barbiturate antagonist, or whether it is an analeptic, it appears to be a useful drug in reversing the respiratory depression and the cerebral depression produced by harbiturate intoxication and barbiturate anesthesia.

Topics: Anesthesia; Antidotes; Barbiturates; Bemegride; Central Nervous System Stimulants; Conjunctiva; Depressive Disorder; Eye; Humans; Respiratory Insufficiency; Sodium, Dietary; Thiamylal; Thiopental

Topics: Adrenal Cortex Hormones; Anesthesia; Anesthesiology; Barbiturates; Humans; Thiopental

Topics: Anesthetics; Barbiturates; Brain; Humans; Neurochemistry; Thiamine Pyrophosphate; Thiopental

Topics: Anesthesia; Barbiturates; Humans; Liver; Protective Agents; Thiopental

Topics: Anesthesia; Anesthesiology; Animals; Barbiturates; Dextrans; Dogs; Ether; Povidone; Rats; Thiopental

Topics: Barbiturates; Humans; Reflex; Stupor; Thiopental; Trigeminal Nerve

Topics: Anesthetics; Anesthetics, Intravenous; Barbiturates; Cardiovascular System; Humans; Thiopental