thiopental and Birth-Weight

To determine the effects of premedication with thiopental on heart rate, blood pressure, and oxygen saturation during semi-elective nasotracheal intubation in neonates.. A randomised, placebo controlled, non-blinded study design was used to study 30 neonates (mean birthweight 3.27 kg) requiring semi-elective nasotracheal intubation. The babies were randomly allocated to receive either 6 mg/kg of thiopental (study group) or an equivalent volume of physiological saline (control group) one minute before the start of the procedure. Six infants were intubated primarily and 24 were changed from orotracheal to a nasotracheal tube. The electrocardiogram, arterial pressure wave, and transcutaneous oxygen saturation were recorded continuously 10 minutes before, during, and 20 minutes after intubation. Minute by minute measurements of heart rate, heart rate variability, mean blood pressure (MBP) and transcutaneous oxygen saturation (SpO(2)) were computed. The differences for all of these between the baseline measurements and those made during and after intubation were determined. Differences in the measurements made in the study and the control groups were compared using Student's t test.. During intubation, heart rate increased to a greater degree (12.0 vs -0.5 beats per minute, p < 0.03) and MBP increased to a lesser degree (-2.9 vs 4.4 mm Hg; p < 0.002) in the infants who were premedicated with thiopental. After intubation only the changes in MBP differed significantly between the two groups (-3.8 vs 4.6 mm Hg; p < 0.001). There were no significant changes in the oxygen saturation between the two groups during or after intubation. The time taken for intubation was significantly shorter in the study group (p < 0.04).. The heart rate and blood pressure of infants who are premedicated with thiopental are maintained nearer to baseline values than those of similar infants who receive no premedication. Whether this lessening of the acute drop in the heart rate and increase in blood pressure typically seen during intubation of unmedicated infants is associated with long term advantages to the infants remains to be determined.

Topics: Birth Weight; Blood Gas Monitoring, Transcutaneous; Blood Pressure; Electrocardiography; Female; Heart Rate; Humans; Hypnotics and Sedatives; Infant, Newborn; Intubation, Intratracheal; Linear Models; Male; Oxygen; Placebos; Premedication; Thiopental; Time Factors

Elective cesarean section was performed in a consecutive series of 30 patients with full-term pregnancies who were not in labor. Epidural (lidocaine, 1.5 per cent, with epinephrine, 1:200,000) and general anesthesia (thiopental, nitrous oxide-oxygen, succinylcholine infusion) was used alternately. Neonatal acid-base values and Apgar scores showed no significant difference between the two anesthetic groups, and most infants were vigorous at birth. The neurologic recoveries of the infants showed no significant difference between the two groups. In the group receiving epidural anesthesia, there was a significant correlation between maternal hypotension and weak rooting and sucking reflexes of the infants during the first two days. All infants of high-risk obstetric patients in the series, independent of anesthetic technique used, had abnormal neurologic activity, as evidenced by either depression of muscle tone and the reflexes or all the tested variables. Neurologic assessment as followed in this series is a sensitive indicator of the effects of fetal stress factors acting during cesarean section.

Topics: Adult; Anesthesia, Epidural; Anesthesia, General; Anesthesia, Obstetrical; Apgar Score; Birth Weight; Cesarean Section; Epinephrine; Female; Humans; Infant, Newborn; Lidocaine; Male; Neurologic Examination; Nitrous Oxide; Pregnancy; Succinylcholine; Thiopental

Arterial blood pressures were taken by the Doppler ultrasound method in 134 unselected mature neonates (birthweights 2,600-3,900 grams) who were managed in the same manner after birth. Blood pressures were measured at 3-5, 10 and 30 minutes of life and, if indicated, intermittently during the next 24-48 h. Left and right arm pressures were identical or differed by only 1-2 mm Hg. Lower than normal blood pressures were found in 4 groups of infants: those born by cesarean section, those recovering from intrauterine asphyxia, those exposed to maternal anti-hypertensive therapy, and those whose mothers received thiopental within four minutes of delivery. Return of the low pressures to within the normal range was fastest following thiopental induction in the absence of fetal asphyxia and slowest after antihypertensive therapy.

Topics: Antihypertensive Agents; Asphyxia Neonatorum; Birth Weight; Blood Pressure; Blood Pressure Determination; Cesarean Section; Female; Fetal Distress; Humans; Hypotension; Infant, Newborn; Pregnancy; Thiopental; Time Factors; Ultrasonography

Topics: Adult; Anesthesia, Endotracheal; Anesthesia, Obstetrical; Apgar Score; Birth Weight; Cesarean Section; Chemical Phenomena; Chemistry; Female; Halothane; Humans; Infant, Newborn; Labor, Obstetric; Pregnancy; Propanidid; Succinylcholine; Thiopental; Time Factors; Toxiferine

Topics: Anesthesia, Inhalation; Anesthesia, Intravenous; Anesthesia, Obstetrical; Anesthetics; Animals; Birth Weight; Delivery, Obstetric; Female; Fetus; Halothane; Humans; Infant, Newborn; Maternal-Fetal Exchange; Nitrous Oxide; Pregnancy; Rabbits; Thiopental; Trichloroethylene

Topics: Adult; Anesthesia, Obstetrical; Barbiturates; Birth Weight; Extraction, Obstetrical; Female; Humans; Obstetric Labor Complications; Parity; Pregnancy; Thiopental

Topics: Anesthesia, Obstetrical; Barbiturates; Birth Weight; Female; Humans; Infant, Newborn; Physical Examination; Pregnancy; Statistics as Topic; Thiopental