thiopental and Asphyxia

Topics: Animals; Animals, Newborn; Asphyxia; Barbiturates; Brain; Carbon Dioxide; Central Nervous System; Female; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Oxygen; Partial Pressure; Pentobarbital; Pregnancy; Respiration; Resuscitation; Thiopental

Lethal injection for execution was conceived as a comparatively humane alternative to electrocution or cyanide gas. The current protocols are based on one improvised by a medical examiner and an anesthesiologist in Oklahoma and are practiced on an ad hoc basis at the discretion of prison personnel. Each drug used, the ultrashort-acting barbiturate thiopental, the neuromuscular blocker pancuronium bromide, and the electrolyte potassium chloride, was expected to be lethal alone, while the combination was intended to produce anesthesia then death due to respiratory and cardiac arrest. We sought to determine whether the current drug regimen results in death in the manner intended.. We analyzed data from two US states that release information on executions, North Carolina and California, as well as the published clinical, laboratory, and veterinary animal experience. Execution outcomes from North Carolina and California together with interspecies dosage scaling of thiopental effects suggest that in the current practice of lethal injection, thiopental might not be fatal and might be insufficient to induce surgical anesthesia for the duration of the execution. Furthermore, evidence from North Carolina, California, and Virginia indicates that potassium chloride in lethal injection does not reliably induce cardiac arrest.. We were able to analyze only a limited number of executions. However, our findings suggest that current lethal injection protocols may not reliably effect death through the mechanisms intended, indicating a failure of design and implementation. If thiopental and potassium chloride fail to cause anesthesia and cardiac arrest, potentially aware inmates could die through pancuronium-induced asphyxiation. Thus the conventional view of lethal injection leading to an invariably peaceful and painless death is questionable.

Topics: Asphyxia; California; Capital Punishment; Humans; Injections, Intravenous; North Carolina; Pancuronium; Potassium Chloride; Thiopental

Topics: Asphyxia; Capital Punishment; Consciousness; Drug-Related Side Effects and Adverse Reactions; Humans; Injections, Intravenous; Kentucky; Pain; Pancuronium; Pharmaceutical Preparations; Potassium Chloride; Prisoners; Thiopental

The effects of anaesthetic agents, per se, on the asphyxiated foetus are difficult to quantitate clinically. Anaesthesia is often necessary in foetal distress, however, to effect a rapid delivery. To investigate the effect of general anaesthetic agents commonly used for Caesarean section we administered these agents to 18 chronically prepared pregnant ewes with asphyxiated foetuses in utero. The foetuses were asphyxiated by partial occlusion of the umbilical cord until foetal arterial pH had decreased from 7.30 to a range of 7.08-7.13. The animals were divided into three groups: Group A which received no anaesthesia and thus served as a control, Group B which received thiopentone (3 mg . kg-1) intravenously followed by 50 per cent nitrous oxide and 0.5 per cent halothane in oxygen for 15 minutes, and Group C which received thiopentone (3 mg . kg-1) followed by one per cent halothane in oxygen for 15 minutes. Foetal cerebral, myocardial, and renal blood flows were measured by injection of radioactive microspheres after production of asphyxia and after 5 and 15 minutes of anaesthesia. General anaesthesia in both groups B and C abolished the hypertension and bradycardia produced by foetal asphyxia secondary to umbilical cord occlusion. There were no significant differences between Groups B and C in foetal pH, PCO2, or PO2. Two foetuses in the nitrous oxide group died after ten minutes of anesthesia, but the aetiology of the sudden demise is unclear. We conclude that general anaesthesia abolishes the foetal response to umbilical cord occlusion and does not improve foetal oxygenation or acid-base status.

Topics: Anesthesia, General; Animals; Asphyxia; Cesarean Section; Female; Fetal Diseases; Fetal Heart; Fetus; Halothane; Heart Rate; Nitrous Oxide; Oxygen; Pregnancy; Renal Circulation; Sheep; Thiopental; Time Factors

Topics: Animals; Asphyxia; Blood Pressure; Body Temperature; Cats; Cervical Plexus; Evoked Potentials; Light; Neurons; Neurons, Efferent; Pain; Pentobarbital; Respiration; Sympathetic Nervous System; Thiopental; Tubocurarine; Visual Perception

Topics: Animals; Asphyxia; Carbon Dioxide; Collapse Therapy; Epinephrine; Ganglia; Ganglia, Spinal; Hyperventilation; Hypoxia; Medulla Oblongata; Nitrogen; Pharmacology; Physiology; Pons; Rabbits; Research; Respiration; Respiration, Artificial; Sympathetic Nervous System; Thiopental; Vagotomy

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, Obstetrical; Asphyxia; Female; Fetus; Humans; Labor, Obstetric; Oxytocin; Pain Management; Pregnancy; Thiopental