thiopental and Genital-Diseases--Female

An intravenous anesthetic drug, propofol was considered to pose antiemetic action. A randomized controlled trial was conducted to evaluate whether propofol could effectively reduce post-operative nausea and vomiting (PONV) compared to thiopental-nitrous oxide (N2O). One-hundred and eight patients undergoing outpatient gynecologic laparoscopy were assigned to receive 3 techniques of anesthesia; thiopental-N2O (T/N), propofol-N2O (P/N) and total intravenous anesthesia (TIVA) using propofol (P/P). The results showed that in the early period (0-5 hours), post-operative nausea in T/N, P/N and P/P groups was 72 per cent, 44 per cent and 31 per cent, respectively (P = 0.002), and post-operative vomiting was 58 per cent, 36 per cent and 11 per cent respectively (P = 0.00014). Patients in the P/N and P/P groups experienced nausea less frequently than the T/N group [relative risk (RR) = 0.62, (95% CI 0.41-0.93) and RR = 0.42 (0.25-0.72) respectively]. Patients in the P/N and P/P groups experienced vomiting less frequently than the T/N group [RR = 0.62 (0.37-1.04) and RR = 0.19 (0.07-0.5) respectively]. Two patients in the T/N group were admitted because of severe nausea and vomiting. In conclusion, TIVA using propofol and propofol-N2O anesthesia can significantly reduce the incidence of PONV in the early period. Concerning the economic crisis of the country as well as the quality of care, propofol-N2O would be the most appropriate anesthetic of choice.

Topics: Adult; Analysis of Variance; Anesthesia, Inhalation; Anesthetics, Combined; Anesthetics, Inhalation; Anesthetics, Intravenous; Antiemetics; Chi-Square Distribution; Female; Genital Diseases, Female; Humans; Laparoscopy; Nitrous Oxide; Postoperative Nausea and Vomiting; Propofol; Risk; Statistics, Nonparametric; Thiopental; Treatment Outcome

Quantitative measurements of coordination ability and performance speed were carried out on 76 female day-case patients undergoing minor gynaecological operations. The women were assigned at random to the anaesthetic agent used, propofol 2.5 mg/kg or thiopentone 4 mg/kg. Spacing control, timing control and performance speed were recorded using a newly developed computerized coordination ability test system. The patients were tested once before the operation and 0.5, 1 and 2 h after awakening. Postoperatively the initial impairment and the subsequent regression towards preoperative test results were very similar whether the anaesthetic agent was propofol or thiopentone. Although the test apparatus was able to detect even minor differences, no postoperative test showed statistically significant differences between the two groups. We find it reasonable to conclude that there is no difference in recovery of coordination ability following propofol- or thiopentone-induced anaesthesia.

Topics: Adolescent; Adult; Ambulatory Surgical Procedures; Anesthesia Recovery Period; Anesthesia, Intravenous; Computer Systems; Female; Genital Diseases, Female; Humans; Middle Aged; Propofol; Psychomotor Performance; Thiopental

This study was designed to compare the ease of performing laryngoscopy and endotracheal intubation without muscle relaxants after the induction of anaesthesia with either thiopentone or propofol in 106 patients scheduled for elective surgery. Thiopentone (5 mg/kg) or propofol (2.5 mg/kg), supplemented with lidocaine (1.5 mg/kg) and alfentanil (30 micrograms/kg), were used in random order for the induction of anaesthesia. Jaw tone, visualisation of the larynx, position of vocal cords, ease of intubation and tolerance of the tracheal tube were assessed. The jaw was relaxed and the vocal cords were immobile/open in most patients in both groups. Visualisation of the larynx was good in 60 and 46% and intubation was easy in 48 and 22% of the patients given thiopentone and propofol, respectively (P less than 0.05 between groups for intubation). After induction of anaesthesia with thiopentone or propofol, endotracheal intubation is not recommended without the use of muscle relaxants.

Topics: Adult; Anesthesia, Intravenous; Female; Genital Diseases, Female; Humans; Intubation, Intratracheal; Laryngoscopy; Middle Aged; Propofol; Single-Blind Method; Succinylcholine; Thiopental

Recovery was assessed over 48 hours after anaesthesia with propofol or thiopentone as sole anaesthetic agent in 36 unpremedicated gynaecological patients. Immediate recovery, as measured by the Steward scale, was shown to be quicker for the patients given propofol. At one hour postoperatively the thiopentone group showed impaired visual-motor coordination on the aiming test (p less than 0.01) and dexterity task (p less than 0.05), and a slowing of reaction time (p less than 0.01). Patients given propofol showed only an increase in reaction time (p less than 0.05). By 2 hours the thiopentone group showed impairment only in the aiming task (p less than 0.05). No further significant impairment was detected at 4, 24 or 48 hours. However, patients reported symptoms throughout the 48 hours indicative of residual drug effects. There was a substantial practice effect with some tests which may have obscured impairment. It can be argued therefore that the better recovery profile after propofol is still evident at 24 hours.

Topics: Adolescent; Adult; Aged; Anesthesia Recovery Period; Anesthesia, General; Anesthesia, Intravenous; Female; Genital Diseases, Female; Humans; Middle Aged; Postoperative Period; Propofol; Psychomotor Performance; Thiopental

Butorphanol/diazepam was compared with thiopental for induction of anesthesia, and the thiopental-sparing effects of butorphanol/diazepam determined. One hundred women, American Society of Anesthesiology physical status class I, undergoing ambulatory, elective termination of pregnancy were randomized to receive either butorphanol 2 mg plus diazepam 10 mg, or thiopental, until loss of the lid reflex occurred. The butorphanol/diazepam group received supplemental thiopental as necessary to attain adequate induction of anesthesia. The combination of butorphanol and diazepam significantly reduced the thiopental dose required to produce loss of the lid reflex, from 4.2 +/- 0.8 to 0.8 +/- 0.6 mg/kg (p less than 0.005), with 22 percent of the patients not requiring supplemental thiopental. The intraoperative course and anesthetic requirements were similar between the two groups. Lower recovery room rating scale values upon arrival at the recovery room were attributed to significantly higher weight-normalized doses of butorphanol (p = 0.004) and diazepam (p = 0.005). The duration of the recovery room stay was 68.8 +/- 24.9 min for the control group, and 80.8 +/- 29.0 min for the butorphanol/diazepam-treated patients (p = 0.026). There were no clinically significant differences in anesthesia or postanesthesia recovery. The combination of butorphanol and diazepam has a significant thiopental-sparing effect, and is a useful induction technique for short, ambulatory surgical procedures.

Topics: Abortion, Induced; Adult; Ambulatory Surgical Procedures; Anesthesia; Butorphanol; Diazepam; Enflurane; Female; Genital Diseases, Female; Humans; Morphinans; Pregnancy; Thiopental

Topics: Adult; Amides; Anesthesia, General; Anisoles; Antiemetics; Benzoates; Clinical Trials as Topic; Ethylamines; Female; Genital Diseases, Female; Halothane; Humans; Middle Aged; Nausea; Nitrous Oxide; Oxygen; Papaverine; Placebos; Preanesthetic Medication; Scopolamine; Thiopental; Vomiting

1. Propofol as an induction agent At a dose of 2 to 2.5 mg.kg-1, as a bolus injection over 30 to 60 seconds, for gynaecological procedures of short duration (abortion, D and C), propofol can be characterized as follows when compared with other induction agents: ADVANTAGES OVER METHOHEXITONE AND ETOMIDATE: decreased incidence of hiccups and abnormal movements, increased quality of induction, similar to that obtained with thiopentone, decreased postoperative nausea and vomiting. ADVANTAGES OVER THIOPENTONE: shorter recovery period, more rapid recovery of consciousness and orientation. DISADVANTAGES WHEN COMPARED WITH THIOPENTONE: more frequent pain at the injection site, however its prevention is possible, more frequent apnoea, but may be avoided by slowly injecting the drug, higher cost. The main advantage of propofol over thiopentone (shorter recovery period), makes day-case gynaecological procedures one of its major indications. This concerns young, healthy women, whose professional and family lives are important and who may benefit from minimal disruption in their way of life. 2. Propofol as a maintenance agent Propofol is given as a continuous infusion at a dose ranging from 6 to 12 mg.kg-1.h-1 for maintenance of prolonged procedures (abdominal surgery, hysterectomy) and can be characterized as follows with respect to halogenated anaesthetics: ADVANTAGES OVER ENFLURANE AND ISOFLURANE: decreased postoperative nausea and vomiting, increased recovery scores (1st hour). COMPARED WITH DESFLURANE: shorter induction time than desflurane, less respiratory problems at induction, similar recovery period, same incidence of nausea and vomiting. The administration of propofol for maintenance of anaesthesia has the main advantage of reducing the incidence of postoperative nausea and vomiting when compared to conventional halogenated anaesthetics. Respective costs of the various techniques, using propofol or the new halogenated anaesthetics, may be a criterion for choice in the future.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anesthesia, Intravenous; Drug Combinations; Etomidate; Female; Fentanyl; Genital Diseases, Female; Humans; Ketamine; Midazolam; Propofol; Thiopental

Topics: Adult; Etomidate; Female; Genital Diseases, Female; Humans; Imidazoles; Middle Aged; Sleep; Thiopental

Topics: Adult; Aged; Anesthesia, Endotracheal; Anesthesia, Intravenous; Bronchoscopy; Female; Fiber Optic Technology; Genital Diseases, Female; Halothane; Humans; Middle Aged; Mucus; Nitrous Oxide; Thiopental; Time Factors; Trachea

Topics: Adult; Anesthesia, Inhalation; Anesthesia, Intravenous; Body Temperature Regulation; Female; Genital Diseases, Female; Genital Neoplasms, Female; Halothane; Humans; Male; Neuroleptanalgesia; Nitrous Oxide; Preanesthetic Medication; Regional Blood Flow; Skin; Thiopental

Topics: Adolescent; Adult; Aged; Anesthesia; Anesthesia, Endotracheal; Child; Ethers; Female; Genital Diseases, Female; Hemodynamics; Humans; Methods; Middle Aged; Postoperative Complications; Pregnanediones; Propanidid; Thiopental

Topics: Adult; Anesthesia, Obstetrical; Atropine; Erythrocytes; Female; Genital Diseases, Female; Glutathione; Glutathione Reductase; Humans; Injections, Intravenous; Thiopental

Topics: Adult; Age Factors; Aged; Anesthesia, Endotracheal; Cesarean Section; Ethyl Ethers; Female; Genital Diseases, Female; Humans; Hysterectomy; Middle Aged; Nitrous Oxide; Ovarian Neoplasms; Pelvic Exenteration; Succinylcholine; Thiopental; Vagina