thiopental and Amnesia

Propofol may produce amnesia by affecting encoding. The hypothesis that propofol weakens encoding was tested by measuring regional cerebral blood flow during verbal encoding.. Seventeen volunteer participants (12 men; aged 30.4 +/- 6.5 yr) had regional cerebral blood flow measured using H2O positron emission tomography during complex and simple encoding tasks (deep vs. shallow level of processing) to identify a region of interest in the left inferior prefrontal cortex (LIPFC). The effect of either propofol (n = 6, 0.9 microg/ml target concentration), placebo with a divided attention task (n = 5), or thiopental at sedative doses (n = 6, 3 microg/ml) on regional cerebral blood flow activation in the LIPFC was tested. The divided attention task was expected to decrease activation in the LIPFC.. Propofol did not impair encoding performance or reaction times, but impaired recognition memory of deeply encoded words 4 h later (median recognition of 35% [interquartile range, 17-54%] of words presented during propofol vs. 65% [38-91%] before drug; P < 0.05). Statistical parametric mapping analysis identified a region of interest of 6.6 cm in the LIPFC (T = 7.44, P = 0.014). Regional cerebral blood flow response to deep encoding was present in this region of interest in each group before drug (T > 4.41, P < 0.04). During drug infusion, only the propofol group continued to have borderline significant activation in this region (T = 4.00, P = 0.063).. If the amnesic effect of propofol were solely due to effects on encoding, activation in the LIPFC should be minimal. Because LIPFC activation was not totally eliminated by propofol, the amnesic action of propofol must be present in other brain regions and/or affect other memory processes.

Topics: Adult; Amnesia; Cerebrum; Dose-Response Relationship, Drug; Electroencephalography; Female; Humans; Hypnotics and Sedatives; Male; Positron-Emission Tomography; Prefrontal Cortex; Propofol; Psychomotor Performance; Thiopental

The authors evaluated the effects of midazolam, propofol, thiopental, and fentanyl on volunteer participants' memory for words and pictures at equisedative concentrations.. Sixty-seven healthy volunteers were randomized to receive intravenous infusions of midazolam (n = 11), propofol (n = 11), thiopental (n = 10), fentanyl with ondansetron pretreatment (n = 11), ondansetron alone (n = 8), or placebo (n = 16) in a double-blind design. Three increasing and then two decreasing sedative concentrations were achieved by computer-controlled infusion in each volunteer. Measures of sedation, memory, and drug concentration were obtained at each target concentration. Drug concentrations were normalized to equisedative effects using both Emax and logistic regression methods of pharmacodynamic modeling. The serum concentrations at 50% memory effect (Cp50s) were determined using four different memory end points. The relative potencies compared with midazolam for memory impairment were determined.. Equisedative concentrations were midazolam, 64.5 +/- 9.4 ng/ml; propofol, 0.7 +/- 0.2 microg/ml; thiopental, 2.9 /- 1.0 microg/ml; and fentanyl, 0.9 +/- 0.2 ng/ml. The Cp50s for 50% loss of memory for words were midazolam, 56 +/- 4 ng/ml; propofol, 0.62 +/- 0.04 microg/ml; thiopental, 4.5 +/- 0.3 microg/ml; and fentanyl, 3.2 +/- 0.4 ng/ml. Compared with midazolam, relative potencies (with 95% confidence intervals) were propofol, 0.96 (0.44-1.78); thiopental, 0.76 (0.52-0.94); and fentanyl, 0.34 (0.05-0.76). Large effects on memory were only produced by propofol and midazolam.. At equal sedation, propofol produces the same degree of memory impairment as midazolam. Thiopental has mild memory effects whereas fentanyl has none. Ondansetron alone has no sedative or amnesic effects.

Topics: Adult; Amnesia; Double-Blind Method; Female; Fentanyl; Humans; Hypnotics and Sedatives; Male; Memory; Midazolam; Middle Aged; Propofol; Thiopental

Numerous reports have described a definite sense of well-being after anesthesia with propofol (Disoprivan). The present study was designed to assess postoperative mood as recorded with a quantitative self-rating method. Postoperative recovery and amnesia were also investigated. Thirty unpremedicated female patients aged 20-60 (ASA grade 1 or 2) who were scheduled for minor gynecological operations were enrolled in the study after informed consent. The patients were randomly allocated to three study groups: group A, induction with propofol 2 mg/kg and maintenance with propofol 0.15 mg/kg per min together with N2O/O2; group B, induction with propofol 2 mg/kg and maintenance with enfluran and N2O/O2; group C, induction with thiopental until loss of the eye lash reflex and maintenance with enfluran and N2O/O2. Postoperative amnesia was assessed by showing five picture cards at 5-min intervals, starting when the patients were able to state the correct date of birth. A test of recovery (p-deletion) was carried out after 30 and again after 60 min. The postoperative mood state was evaluated with the adjective checklist of Janke and Debus 5 h after waking. In good agreement with published reports, propofol patients recovered more rapidly than thiopental patients. A significant but irrelevant amnesia occurred after 5 min in group B. However, in some cases amnesia lasting up to 20 min was observed. The global mood status showed a significantly higher score for positive items and a lower score for negative items after propofol administered by either technique than after thiopental (P = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Affect; Amnesia; Anesthesia Recovery Period; Anesthesia, Intravenous; Female; Humans; Middle Aged; Propofol; Randomized Controlled Trials as Topic; Thiopental

Topics: Adult; Amnesia; Amnesia, Retrograde; Anesthesia, Inhalation; Benzodiazepines; Clinical Trials as Topic; Diazepam; Female; Hemodynamics; Humans; Male; Memory; Middle Aged; Phlebitis; Solubility; Thiopental; Time Factors; Water

Three groups of 50 patients were anaesthetized with diazepam 0.32 mg/kg or thiopentone 3.7 mg/kg or propanidid 4.6 mg/kg for elective carfioversion. Propanidid caused more hypotension than diazepam or thiopentone. Apnoea was most frequent following thipentone and excitatory side-effects were most prominent following propanidid; the electric countershock worsened the excitatory phenomena. The success rate of conversion was higher in the diazepam group than in the other groups, but the difference was not statistically significant. Diazepam failed to produce amnesia in about 33% of the patients. Thiopentone is suitable and pleasant for cardioversion. Diazepam is recommended in poor-risk patients and in emergency situations.

Topics: Adult; Aged; Amnesia; Anesthesia, General; Apnea; Arrhythmias, Cardiac; Blood Pressure; Cardiac Complexes, Premature; Diazepam; Electric Countershock; Female; Heart Rate; Humans; Male; Middle Aged; Propanidid; Thiopental

Topics: Adolescent; Adult; Amnesia; Anesthesia, Intravenous; Anesthetics; Diazepam; Female; Humans; Methohexital; Pregnancy; Propanidid; Thiopental

In view of the rapid and complete recovery, the low incidence of hangover, nausea or vomiting, propofol can be considered as first choice agent for minor surgery, short operations and/or day-case surgery. For long and major procedures it is of no advantage over the thiopental-isoflurane technique. For a rapid recovery, the dose should be titrated, particularly during the closing stage of the procedure. As propofol has some amnesic properties, any instructions given to the patient postoperatively should be in writing. Sexual thoughts resulting from disinhibition may occur during emergence; therefore, it is recommended to have a third party present to avoid any implications of misconduct.

Topics: Amnesia; Anesthesia Recovery Period; Anesthesia, Intravenous; Drug Delivery Systems; Etomidate; Humans; Ketamine; Midazolam; Propofol; Thiopental; Titrimetry; Wakefulness

A case of generalised dissociative amnesia is presented, which illustrates several characteristic features of this uncommon condition. The case showed poor response to thiopentone interviews and in vivo cueing. Amnesia had persisted at six months follow up.

Topics: Adult; Amnesia; Dissociative Disorders; Humans; India; Interview, Psychological; Male; Mental Recall; Social Environment; Thiopental

Topics: Amnesia; Humans; Thiopental

Twenty patients aged 45 or older with the diagnosis of endogenous depression were evaluated in terms of safety and efficacy in their response to multiple monitored electroconvulsive therapy (MMECT) versus single electroconvulsive therapy (SECT). The MMECT group (10 patients) when compared retrospectively with the control SECT group (10 patients) showed a similar record for safety and efficacy. However, the MMECT group required shorter overall duration of treatment, fewer sessions of general anesthesia, and lower dosages of anesthetic agents. The chief benefit of MMECT probably is in the reduction of the time the patient is at risk for suicide.

Topics: Adult; Aged; Amnesia; Depression; Electroconvulsive Therapy; Electroencephalography; Humans; Middle Aged; Outcome and Process Assessment, Health Care; Schizophrenia; Succinylcholine; Thiopental

Topics: Amnesia; Anesthesia, Intravenous; Anesthesia, Obstetrical; Apgar Score; Atropine; Cesarean Section; Consumer Behavior; Creatine Kinase; Diazepam; Female; Humans; Infant, Newborn; Nitrous Oxide; Pain; Preanesthetic Medication; Pregnancy; Stimulation, Chemical; Succinylcholine; Thiopental

Topics: Adult; Amnesia; Anesthesia, General; Female; Halothane; Humans; Knowledge of Results, Psychological; Male; Memory; Memory, Short-Term; Methoxyflurane; Thiopental; Time Factors

Topics: Amnesia; Analgesics; Animals; Anticonvulsants; Anxiety; Appetite; Ataxia; Behavior, Animal; Benzodiazepinones; Blood Pressure; Chlorobenzenes; Dose-Response Relationship, Drug; Drug Interactions; Haplorhini; Heart Rate; Humans; Mice; Morphine; Muscle Relaxants, Central; Muscles; Rats; Seizures; Sleep; Structure-Activity Relationship; Thiopental; Tranquilizing Agents

Topics: Amnesia; Anesthesia, Intravenous; Benzodiazepinones; Blood Pressure; Cardiac Surgical Procedures; Depression, Chemical; Diazepam; Female; Heart Rate; Humans; Hysterectomy; Male; Muscles; Postoperative Complications; Sleep; Thiopental; Vomiting

Topics: Adolescent; Adult; Aged; Amnesia; Anesthesia, General; Apnea; Bronchoscopy; Cognition; Consciousness; Diazepam; Humans; Laryngoscopy; Male; Middle Aged; Preanesthetic Medication; Thiopental

Topics: Adult; Amnesia; Anesthesia, General; Brain; Female; Humans; Immobilization; Intracranial Pressure; Male; Middle Aged; Nitrous Oxide; Oxygen; Thiopental; Unconsciousness

Topics: Amnesia; Diazepam; Female; Humans; Hysterectomy; Injections, Intravenous; Nausea; Preanesthetic Medication; Thiopental; Vomiting

Topics: Amnesia; Arrhythmias, Cardiac; Diazepam; Electric Countershock; Female; Humans; Injections, Intravenous; Male; Meperidine; Methods; Middle Aged; Thiopental

Topics: Accidents; Amnesia; Anesthesia; Apnea; Central Nervous System; Convulsive Therapy; Depression; Electroconvulsive Therapy; Fear; History, 20th Century; Humans; Injections, Intravenous; Methods; Pentylenetetrazole; Thiopental; Thrombophlebitis

Topics: Amnesia; Anesthesia, Intravenous; Blood Pressure; Diazepam; Humans; Liver; Methohexital; Pulse; Thiopental

Topics: Adult; Amnesia; Anesthesia, General; Atropine; Female; Halothane; Humans; Male; Meperidine; Nitrous Oxide; Pentobarbital; Postoperative Complications; Preanesthetic Medication; Psychological Tests; Thiopental

Topics: Amnesia; Anesthesia, Intravenous; Blood Pressure; Diazepam; Female; Humans; Hysterectomy; Muscles; Postoperative Complications; Respiration; Thiopental; Uterine Cervical Neoplasms; Vomiting

Topics: Amnesia; Barbiturates; Cystoscopy; Female; Pregnancy; Sodium; Thiopental

Topics: Amnesia; Barbiturates; Cystoscopy; Humans; Sodium; Thiopental