thiopental and Brain-Diseases

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Four of the seven papers used thiopental alongside other neuroprotective methods and agents. The methods included the use of ice packs to the head and core systemic hypothermia. Agents used alongside thiopental included nicardipine and mannitol. Thiopental was found to have the ability to lower oxygen consumption, where oxygen consumption was measured using the phosphocreatinine and adenosine triphosphate ratio. The neuroprotective effect of thiopental was evaluated by assessing the electrical activity of the brain during circulatory arrest, by which it was shown to be advantageous. However, other trials suggested that adding thiopental during circulatory arrest did not provide any extra protection to the brain. The timing of thiopental administration is of importance in order to gain positive outcomes, as it's ability to lower the cerebral energy state may result in unfavourable results if added before hypothermic circulatory arrest, where this may lead to an ischaemic event. We conclude that the use of thiopental during deep hypothermic circulatory arrest is beneficial, but if administered too early, it may replete the cerebral energy state before arrest and prove to be detrimental.

Topics: Benchmarking; Brain; Brain Diseases; Circulatory Arrest, Deep Hypothermia Induced; Energy Metabolism; Evidence-Based Medicine; Female; Humans; Male; Middle Aged; Neuroprotective Agents; Oxygen Consumption; Thiopental; Treatment Outcome

It has been over 40 years since the term "neuroanesthesia" emerged. The anesthesiologists specializing in neuroanesthesia have actively conducted basic research on cerebral ischemia as well as on cerebral blood flow and metabolism. However, translating the results of basic research using experimental animals into clinical applications has been often unsuccessful, especially in the area of cerebral ischemia. The negative results produced by a series of hugely costly and time-consuming collaborative multicenter trials have disappointed many researchers. It could be argued that discrepancies in the efficacy of an agent ought to be viewed in the context of the differences between experimental animals and humans since they have considerably different higher-order functions, and consequently the relevance of using experimental animals is brought into question. Nevertheless, the accuracy of basic research can be improved by taking measures to reduce bias. Taking such measures may enable more careful judgments to be made at the basic research stage and prevent unnecessary clinical studies. Although it could be seen as taking a slight detour, it is advisable to create a system that facilitates confirmation of the original findings by a multicenter basic research project before starting a collaborative multicenter clinical trial.

Topics: Anesthesia; Anesthetics, Intravenous; Animals; Brain Diseases; Humans; Neurosurgery; Postoperative Complications; Thiopental; Translational Research, Biomedical; Treatment Outcome

Topics: Adenosine Triphosphate; Anesthesia; Anesthetics; Aneurysm; Animals; Barbiturates; Brain; Brain Diseases; Brain Ischemia; Cerebrovascular Circulation; Electroencephalography; Energy Metabolism; Humans; Hypothermia, Induced; Intraoperative Complications; Isoflurane; Naloxone; Phenytoin; Thiopental

Signal intensity changes in fMRI during rest caused by vasomotor fluctuations were investigated in this work. Resting-state baseline fluctuations were evaluated in 12 children anesthetized with thiopental. Five subjects had fluctuations related to subvoxel motion. In seven subjects without significant motion, slow signal fluctuation at 0.025-0.041 Hz near one or more primary sensory cortices was observed. In each subject the amplitude and frequency of the fluctuations were stable. It is hypothesized that thiopental, which reduces blood pressure and flow in the cortex, alters the feedback in neurovascular coupling leading to an increase in the magnitude and a reduction in the frequency of these fluctuations. The use of anesthesia in fMRI may provide new insight into neural connectivity and the coupling of blood flow and neural metabolism.

Topics: Anesthesia, Intravenous; Artifacts; Blood Pressure; Brain; Brain Diseases; Cerebrovascular Circulation; Child; Child, Preschool; Female; Fourier Analysis; Humans; Infant; Magnetic Resonance Imaging; Male; Motion; Phantoms, Imaging; Signal Processing, Computer-Assisted; Somatosensory Cortex; Thiopental; Vasomotor System

The results of the multiple-modality treatment of epilepsy in 56 children of different age with the use of thiopental-sodium are presented. It has been shown that its early administration to children with a true status epilepticus makes it possible to faster bring the patient out of the pathologic condition as compared to the conventional methods of treatment. In patients with a symptomatic epistatus and in children with marked residual-organic cerebral insufficiency associated with the development of convulsions anticonvulsive therapy should be combined with the treatment of the underlying disease aimed at the correction of extra- and intracranial homeostasis.

Topics: Adolescent; Brain Diseases; Child; Child, Preschool; Clinical Trials as Topic; Combined Modality Therapy; Critical Care; Electroencephalography; Female; Humans; Infant; Infant, Newborn; Male; Monitoring, Physiologic; Status Epilepticus; Thiopental

A prospective study of 204 patients undergoing operations requiring cardiopulmonary bypass was undertaken to determine the incidence and etiologic factors leading to postperfusion cerebral dysfunction and to determine whether pretreatment with thiopental, 15 mg/kg, would reduce the incidence. Patients were randomly assigned to a control (diazepam) or study (thiopental) group and were treated identically except for the drug administered. Patients were examined neurologically on the 1st and 4th postoperative day and a psychometric test was administered on the 4th day. Although fewer neuropsychiatric complications were present in patients given thiopental, the difference was not significant. The overall incidence of cerebral dysfunction attributable to cardiopulmonary bypass alone was 16.2% for transient and 6.4% for persistent dysfunction (present at the 10th postoperative day). The incidence of postoperative cerebral dysfunction was more than twice as high in patients undergoing intracardiac than in patients having extracardiac operations and more than 4 times as high in patients more than 60 years of age than in younger patients. Perfusion pressure less than 50 torr with hematocrit less than 30% was not related to development of postoperative cerebral dysfunction. The data suggest that air or particulate emboli originating within the heart or aorta are the major causes of postbypass cerebral dysfunction.

Topics: Adult; Brain Diseases; Cardiopulmonary Bypass; Clinical Trials as Topic; Diazepam; Female; Humans; Male; Middle Aged; Psychophysiologic Disorders; Thiopental

Long term intracranial pressure (ICP) monitoring was carried out in over 200 patients with various intracranial abnormalities; a fiberoptic epidural intracranial pressure monitor was used. Ninety of these patients had significantly elevated ICP or exhibited pressure waves requiring therapy. Initial therapy consisted of hyperventilation with a respirator and administration of hyperosmotic agents. Comparison studies utilizing 30% urea, 20% mannitol, and furosemide intravenously and 30% urea and 10% glycerol orally were randomly done. In 45 patients two or more of these agents were used at different times in the same patient for comparison of effectiveness. When equimolar amounts of intravenous urea and mannitol were used, similar effects on increased ICP were obtained. There was no significant reduction of increased ICP with the use of furosemide alone. No rebound effect was observed with either mannitol or urea. Orally, urea was more effective than glycerol in equimolar amounts. Again no rebound was observed. In 14 patients who required doses of hyperosmotic agents more frequently than every 4 hours, continuous infusion of thiopental was used in conjunction with the hyperosmotic agents to control pressure. This regimen resulted in good ICP control in 12 patients. A rational protocol for the medical management of increased ICP utilizing hyperosmotic agents and, in refractory cases, hyperosmotic agents plus thiopental has resulted in effective control of ICP in 96% of our patients throughout their course without the need to resort to decompressive surgery. (Neurosurgery, 5: 570--575, 1979).

Topics: Brain Diseases; Diuretics, Osmotic; Drug Therapy, Combination; Furosemide; Glycerol; Humans; Intracranial Pressure; Mannitol; Thiopental; Urea

Topics: Adolescent; Adult; Aged; Anesthesia, General; Brain Diseases; Brain Neoplasms; Carbon Dioxide; Cerebral Angiography; Cerebrovascular Disorders; Child; Child, Preschool; Craniocerebral Trauma; Droperidol; Female; Fentanyl; Humans; Male; Middle Aged; Neuroleptanalgesia; Nitrous Oxide; Partial Pressure; Thiopental

Topics: Anticonvulsants; Brain Diseases; Child, Preschool; Electroencephalography; Extracorporeal Membrane Oxygenation; Heart Diseases; Humans; Male; Seizures; Thiopental; Treatment Outcome

The cerebral metabolic effects of a massive dose of thiopental (177 mg/kg) were investigated in seven dogs. The systemic circulation was supported with an extracorporeal circuit. At an infusion rate of 2 mg/kg/min, cerebral oxygen consumption (CMR(O(2))) decreased progressively until cerebral electrical silence was produced. This occurred after a mean dose of 72 mg/kg, which caused a mean decrease in CMR(O(2)) to 58% of the control value (measured at 1.5% halothane inspired). Thereafter, despite continued at 4 mg/kg/min, CMR(O(2)) did not decrease further. The oxygen-glucose index never changed during the infusion period and, at the termination of the infusion, brain assays for ATP, phosphocreatine, lactate, and pyruvate revealed normal concentrations. It is concluded that there was no alteration in normal cerebral metabolic pathways, that cerebral metabolic effects of thiopental are secondary to functional effects, that thiopental would provide no cerebral protection during hypoxia sufficient to abolish cerebral function, and that thiopental does not uncouple oxidative phosphorylation.

Topics: Anesthetics; Animals; Brain Chemistry; Brain Diseases; Dogs; Electroencephalography; Heart Arrest; Hypnotics and Sedatives; Oxygen Consumption; Thiopental

Topics: Adrenal Cortex Hormones; Anesthesia, Intravenous; Animals; Brain Diseases; Diazepam; Dog Diseases; Dogs; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Hypnotics and Sedatives; Male; Phenobarbital; Thiopental

We compared the efficacy of four different classes of anesthetics to arrest the progression of brain damage after chemoconvulsant-induced seizures in rats. In two series of experiments, ventilated, paralyzed Long-Evans rats were subjected to 30 or 45 min of continuous seizures induced by intravenous (IV) mercaptopropionic acid (MPA) or inhaled flurothyl, respectively. In the first series, seizures produced with MPA were treated with: 1) thiopental, 15 mg/kg IV bolus (controls); 2) thiopental, 27 mg/kg IV followed by 20.9 mg.kg-1.h-1 for 2 h; 3) isoflurane 4% inhaled concentration for 1 min followed by 1%-2% for 2 h; 4) ketamine 30 mg/kg IV followed by 9.12 mg.kg-1.h-1 for 2 h; 5) midazolam 25 mg/kg IV followed by 9.7 mg.kg-1.h-1 for 2 h. In a second series, seizures were produced by flurothyl and, based on suggestive results in the MPA series, control rats were compared with rats receiving midazolam 25 mg/kg IV followed by 9.7 mg.kg-1.h-1. In all instances, seizure activity, recorded by electroencephalograph, stopped with anesthetic treatment. In MPA-treated rats extranigral damage was mild, with no differences apparent between anesthetics. Control animals sustained severe lesions in the substantia nigra pars reticulata (SNPR). No statistically significant differences between anesthetic groups were present, although an effect was suggested for midazolam to decrease SNPR lesional area (P = 0.06). In flurothyl-treated rats, there were significant reductions in SNPR neuropathologic grade (P = 0.025) and lesional area (P = 0.025) with midazolam. We conclude that midazolam attenuates postseizure SNPR damage in rats.

Topics: 3-Mercaptopropionic Acid; Administration, Inhalation; Anesthetics; Animals; Brain Diseases; Flurothyl; Infusions, Intravenous; Isoflurane; Ketamine; Male; Midazolam; Rats; Status Epilepticus; Thiopental

Topics: Anesthesia, Intravenous; Anesthetics; Brain Diseases; Drug Administration Schedule; Female; Hemodynamics; Humans; Intracranial Pressure; Male; Middle Aged; Phenols; Propofol; Thiopental

High-dose thiopental was administered in 8 children with uncontrollable seizures or hypoxic encephalopathy (group A) and 7 full-term neonates with neonatal asphyxia (group B). All of them were submitted to artificial hyperventilation to maintain pCO2 near 3.5 kPa. Rectal temperature was kept at about 35 degrees C. Thiopental was infused with a rate of 2-4 mg X h-1 X kg-1, with treatment lasting 32-192 h for group A (mean 103 h), and 36-48 h for group B (mean 38.5 h). Plasma concentration-time data were analysed pharmacokinetically. Thiopental elimination half-life was 14.5 h (group A) and 20.9 h (group B). The clearance of thiopental was 0.27 liters X h-1 X kg-1 (group A) and 0.32 liters X h-1 X kg-1 (group B). The volume of distribution at steady-state was 5.41 liters X kg-1 (group A) and 8.26 liters X kg-1 (group B). These results show that high-dose thiopental pharmacokinetics is not very different for full-term newborns, children and adults. Elimination half-life and volume of distribution are changed when compared to single-dose studies, while clearance is only slightly modified. The time for disappearance of thiopental from blood is also very long (2 to 5 days). These pharmacokinetic characteristics would be worthy of consideration in cases where there may be prolonged use of thiopental, considering the risk of accumulation and toxicity.

Topics: Brain Diseases; Child; Half-Life; Humans; Hypoxia, Brain; Infant; Infant, Newborn; Kinetics; Thiopental

Topics: Acute Disease; Adult; Brain Diseases; Critical Care; Female; Humans; Intracranial Pressure; Male; Middle Aged; Thiopental

To assess the uses of high dose barbiturate therapy in neurosurgery and intensive care, the authors have undertaken a concise survey of relevant experimental investigations and a comprehensive review of published clinical experiences.

Topics: Barbiturates; Brain; Brain Diseases; Brain Edema; Brain Ischemia; Cerebrovascular Circulation; Critical Care; Dose-Response Relationship, Drug; Electroencephalography; Energy Metabolism; Humans; Intracranial Pressure; Lipid Peroxides; Oxygen Consumption; Pentobarbital; Phenobarbital; Thiopental

Carotid endarterectomy was performed 28 times in 27 patients. All but one patient had symptomatic carotid artery disease, 59% had bilateral disease and 59% had associated intracranial disease. Barbiturate therapy was used as a means of cerebral protection during carotid artery cross-clamping. Neurological deficit occurred in two patients, being permanent in one patient (3.5%); both patients had bilateral carotid and intracranial disease and both had carotid stump pressures greater than 55 mmHg. No morbidity could be attributed to barbiturate usage.

Topics: Adult; Aged; Anticoagulants; Blood Pressure; Brain Diseases; Carotid Arteries; Carotid Artery Diseases; Cerebrovascular Disorders; Constriction; Endarterectomy; Female; Humans; Intraoperative Complications; Ischemic Attack, Transient; Male; Middle Aged; Postoperative Complications; Risk; Thiopental

Traditional visual inspection of electroencephalographic (EEG) tracings and computer-assisted topographic mapping were compared in their abilities to detect and locate supratentorial lesions following intravenous sodium thiopental administration. Of the 13 subjects, 8 had atrophic and 5 had mass lesions, all defined by computed tomographic scan and 11 confirmed at operation. EEGs made before and after thiopental administration were evaluated separately from topographic maps of statistical difference between EEGs at multiple frequency ranges made before and after thiopental injection. Topographic mapping of statistical difference accurately detected all thirteen lesions, whereas EEG detected eight. In addition to demonstrating reduced beta production overlying structural abnormalities, topographic mapping revealed regionally augmented beta, especially over irritative lesions. Moreover, localization was possible with the topographic method after the first thiopental injection, whereas a second injection was required for EEG localization by visual inspection. Changes in slow (delta) activity were also useful in delineation of atrophic lesions, in which delta was usually augmented but occasionally regionally reduced. Multielectrode studies with topographic mapping appear essential in delineating cerebral abnormalities, because both slow and fast activities may be increased or reduced over such areas. The relative response of EEG background activity to thiopental at different frequencies may assist lesion characterization as well as localization.

Topics: Adolescent; Adult; Brain; Brain Diseases; Brain Mapping; Child; Child, Preschool; Electroencephalography; Female; Humans; Male; Nervous System Diseases; Thiopental; Tomography, Emission-Computed; Tomography, X-Ray Computed

Thirty patients with an acute midbrain syndrome were treated by high dose barbiturate therapy. Of these patients 19 had a severe head injury. In 8 patients the symptoms of acute midbrain syndrome developed after subarachnoid haemorrhage. In three patients these symptoms were caused by postoperative swelling or ischaemia. The results of those patients, who were treated with barbiturates after head injury were much better than in 16 other patients, who had no barbiturates. The indications for high dose barbiturate therapy in neurosurgery are discussed with reference to other publications and to the pathophysiological effects of barbiturates.

Topics: Adolescent; Adult; Brain Diseases; Brain Injuries; Humans; Mesencephalon; Middle Aged; Neurosurgery; Postoperative Complications; Subarachnoid Hemorrhage; Syndrome; Thiopental

Massive intraoperative brain swelling is an infrequent but catastrophic occurrence. In this report, we describe the use of very large doses of thiopental as a means of treating such swelling. In our initial 11 cases (5 arteriovenous malformations, 4 hematomas, and 2 penetrating injuries), this approach produced the following outcomes: 6 patients made a good recovery, 2 are moderately disabled, 1 is severely disabled, and 2 are dead. These results indicate that this condition, which once was considered unmanageable, can indeed be managed and that treatment often results in an acceptable outcome. More recent experience in an additional 6 patients suggests that the use of planned deep thiopental anesthesia, with induced cerebral silence, during intracranial surgery may even prevent the occurrence of this phenomenon.

Topics: Brain Diseases; Brain Edema; Brain Injuries; Dose-Response Relationship, Drug; Hematoma, Epidural, Cranial; Hematoma, Subdural; Humans; Intracranial Arteriovenous Malformations; Intraoperative Complications; Prognosis; Thiopental

During an aortocoronary bypass procedure, the patient suffered an air embolism arising from technical difficulties with the extracorporeal circulatory device. Initial emergency treatment included a loading dose of thiopental concomitant to a one hour period profound hypothermia. A modified protocol for treating patients with acute head injuries was the initiated. It combined moderate hypothermia with continuous barbiturate coma for 96 hours. Brain activity in this patient returned on the third postoperative day. She recovered completely, with no detectable neurologic damage.

Topics: Brain Diseases; Catheterization; Coronary Artery Bypass; Embolism, Air; Equipment Failure; Female; Humans; Hypothermia, Induced; Iatrogenic Disease; Middle Aged; Thiopental

To define the utility of high-dose barbiturate therapy following an episode of complete global cerebral ischemia, we investigate the effects of 60 mg/kg of thiopental given to cats five minutes after resuscitation from 12, 14, or 16 min of electrically induced ventricular fibrillation (VF). All aspects of the arrest, resuscitation, with post-arrest care were carefully controlled, with the EEG becoming isoelectric 20-25 s after the onset mean resuscitation time of 2.5 +/- 0.2 (SEM) min. For any given duration of VF, there were no differences (control vs thiopental) in any pre- or post-arrest parameters (blood pressure, blood gases, electrolytes, etc.) A total of 68 resuscitated cats were entered into various treatment and control groups, and all but one group received 20-24 h of post-resuscitation paralysis, mechanical ventilation, and ICU support before being extubated. Cats received an additional six days of aggressive nursing care, and daily examinations were performed with the assignment of a neurologic deficit score (NDS) between 0 (normal) and (brain dead). Autopsies were performed to determine the cause of death in animals which died before the end of the seven-day observation period. The early post-arrest period was marked by the occurrence of repetitive, rhythmic bursts of high-frequency electroencephalographic (EEG) activity (? seizures) in 38 per cent of control animals (16/42, all arrest times combined). Ten of these animals died as a result of severe neurologic injuries. By contrast, only 12 per cent of treated cats (3/26) developed similar EEG patterns (P less than 0.05) and there were no neurologic deaths in the thiopental groups. The differences in the incidence of neurologic deaths (control vs. thiopental) was significant (P less than 0.02). The change in overall mortality did not quite reach significance (36 per cent vs. 21 per cent), and treatment had no effect on the incidence of deaths due to cardiovascular causes (e.g., myocardial infarctions). In spite of the effects on mortality, treatment had no effect on the neurologic function of survivors (assessed by NDS). These findings suggest that thiopental improved survival rates by suppressing an unusual post-arrest EEG pattern (? anticonvulsant effect), but had no additional cerebral protective effects.

Topics: Animals; Brain Diseases; Brain Ischemia; Cats; Disease Models, Animal; Electroencephalography; Heart Arrest; Resuscitation; Thiopental; Ventricular Fibrillation

Topics: Anesthesia; Brain Diseases; Humans; Infant; Infant, Newborn; Ketamine; Male; Myoclonus; Syndrome; Thiopental

Topics: Adult; Brain Diseases; Female; Heart Arrest; Humans; Male; Middle Aged; Thiopental

Topics: Brain Diseases; Child, Preschool; Dexamethasone; Drug Therapy, Combination; Female; Humans; Intracranial Pressure; Mannitol; Monitoring, Physiologic; Thiopental

The influence of thiopental (Pentothal) on cerebral blood flow was studied by means of ten scintillationcounters in man on occasion of a carotid angiography. The patients received a basic anesthesia with 30% oxygen, 70% nitrous oxide and pancuronium bromide. When the anesthesia was stabilised, thiopental was given (4 mg/kg). The influence of barbiturates on autoregulation is discussed.

Topics: Anesthesia; Blood Pressure; Brain Diseases; Cerebrovascular Circulation; Homeostasis; Humans; Thiopental

Topics: Anesthesia, General; Atropine; Brain Diseases; Carbon Dioxide; Carotid Arteries; Cerebral Angiography; Cerebral Ventriculography; Cerebrovascular Circulation; Child; Child, Preschool; Humans; Infant; Intracranial Pressure; Myelography; Pneumoencephalography; Postoperative Complications; Preanesthetic Medication; Respiration, Artificial; Succinylcholine; Thiopental

Topics: Adolescent; Blood Pressure; Brain Diseases; Brain Neoplasms; Child; Child, Preschool; Coma; Craniocerebral Trauma; Female; Humans; Hypothermia, Induced; Intracranial Pressure; Male; Middle Aged; Pentobarbital; Perfusion; Respiration, Artificial; Skull Fractures; Thiopental

Topics: Anesthesia, Intravenous; Blood Pressure; Brain Diseases; Child; Humans; Injections, Intravenous; Intracranial Pressure; Ketamine; Respiration; Stimulation, Chemical; Thiopental

Topics: Animals; Arteries; Blood Pressure; Brain Diseases; Brain Neoplasms; Central Venous Pressure; Dogs; Dura Mater; Halothane; Heart Rate; Intracranial Pressure; Nitrous Oxide; Oxygen; Pupil; Respiration, Artificial; Succinylcholine; Thiopental

Topics: Adolescent; Adult; Brain Diseases; Child; Child, Preschool; Diagnosis, Differential; Epilepsy; Epilepsy, Absence; Humans; Thiopental

Topics: Anesthesia, General; Brain Diseases; Diazepam; Female; Humans; Male; Positive-Pressure Respiration; Respiratory Insufficiency; Succinylcholine; Thiopental

Topics: Brain Diseases; Electroencephalography; Epilepsy; Epilepsy, Absence; Humans; Methods; Neurologic Manifestations; Thiopental

Topics: Brain Diseases; Electroencephalography; Epilepsy; Epilepsy, Post-Traumatic; Humans; Injections, Intravenous; Sleep Stages; Thiopental

Topics: Brain Diseases; Electromyography; Humans; Muscle Contraction; Muscles; Procaine; Reflex; Reflex, Stretch; Sciatic Nerve; Spinal Nerves; Thiopental; Triazines; Vibration

Topics: Anesthesia; Anesthesia, Endotracheal; Brain; Brain Diseases; Brain Neoplasms; Humans; Hydroxyzine; Hyperventilation; Intracranial Pressure; Neurosurgery; Osmosis; Respiration, Artificial; Succinylcholine; Thiopental

The effects of certain drugs on metabolism of ammonia by the liver and kidneys in dogs were investigated by a technique in which both hepatic inflow and outflow bloods could be repeatedly sampled in unanesthetized healthy animals. Specific representatives of the classes of the drugs studied included thiopental (barbiturates), morphine (opiates and analgesics), promazine (tranquillizers), and chlorothiazide (oral diuretics).The three drugs commonly used as sedatives were all found to impair the ability of the liver to metabolize ammonia. The diuretic, by contrast, increased the amount of ammonia put into the systemic system by the kidneys. Ethanol appeared to have little or no direct effect on ammonia metabolism.The possibility exists that the occurrence of acute hepatic encephalopathy in patients with severe liver disease may be avoided in many cases if these drugs are administered with proper care. Results also indicated that current concepts of the pharmacological action of sedatives, opiates and tranquillizers may require revision.

Topics: Amines; Ammonia; Animals; Blood Chemical Analysis; Brain Diseases; Chlorothiazide; Diuretics; Dogs; Ethanol; Hepatic Encephalopathy; Kidney; Liver; Liver Diseases; Metabolism; Morphine; Neurologic Manifestations; Promazine; Thiopental; Toxicology

Topics: Barbiturates; Brain Diseases; Cerebral Cortex; Electroencephalography; Humans; Thiopental