thiopental and Liver-Diseases

Topics: Anesthetics; Critical Care; Dose-Response Relationship, Drug; Drug Tolerance; Fentanyl; Hexobarbital; Humans; Liver; Liver Diseases; Sepsis; Stress, Physiological; Thiopental

In 32 patients with chronic liver disease, undergoing major abdominal surgery, anaesthesia was induced with either Althesin (alphaxalone and alphadolone acetate) or thiopentone, and maintained with nitrous oxide, oxygen and increments of either pethidine or fentanyl. The patients were ventilated artificially to maintain PaCO, values in the normal range. Pancuronium bromide was used as the muscle relaxant. Liver function tests at 24 hr and 5 day after surgery showed only minor changes compared with findings before operation. There was no significant difference between the Althesin and thiopentone groups. In two patients with severe obstructive jaundice there was difficulty in reversing the effects of pancuronium, but "pancuronium resistance" was observed in all patients. It is concluded that the anaesthetic sequence described, with either Althesin or thiopentone induction, is satisfactory with respect to changes in liver function in patients with chronic liver disease undergoing major surgery.

Topics: Adolescent; Adult; Aged; Alkaline Phosphatase; Anesthesia, General; Chronic Disease; Humans; Liver Diseases; Liver Function Tests; Middle Aged; Nitrous Oxide; Pancuronium; Pregnanediones; Serum Albumin; Thiopental

Topics: Acepromazine; Animals; Atropine; Chemical and Drug Induced Liver Injury; Dog Diseases; Dogs; Drug Interactions; Female; Liver; Liver Diseases; Methoxyflurane; Necrosis; Pentazocine; Thiopental

A case of acute hepatic failure is described following multiple general anaesthetics administered for the treatment of cranio-facial trauma. The dangers of multiple anaesthetics within a short period is stressed. The possibility that unexplained pyrexia following a general anaesthetic may be and early warning sign is mentioned in relation to this case. The subsequent development of the Henoch-Schönlein syndrome is reported, and the occurrence of the two conditions in the same patient is thought to be possibly unique.

Topics: Acute Disease; Adult; Anesthesia, General; Facial Injuries; Halothane; Humans; IgA Vasculitis; Liver Diseases; Male; Nitrous Oxide; Skull; Succinylcholine; Thiopental

Topics: Animals; Chemical and Drug Induced Liver Injury; Chloroform; Endoplasmic Reticulum; Halothane; Hypertrophy; Liver Diseases; Liver Glycogen; Male; Mice; Microscopy, Electron; Mitochondria, Liver; Phenobarbital; Thiopental

Topics: Alanine Transaminase; Alkaline Phosphatase; Anesthesia; Anesthesia, General; Aspartate Aminotransferases; Bilirubin; Blood Proteins; Chemical and Drug Induced Liver Injury; Clinical Enzyme Tests; Cyclopropanes; Ethers; Halothane; Hepatitis; Hepatitis A; Liver Diseases; Liver Function Tests; Retrospective Studies; Statistics as Topic; Thiopental; Thymol; Toxicology; Trichloroethylene; Zinc

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: Analgesia; Anesthesia; Anesthesia and Analgesia; Liver Diseases; Pain Management; Sodium; Thiopental

Topics: Gastrointestinal Diseases; Liver Diseases; Stupor; Thioctic Acid; Thiopental; Vitamin A; Vitamin K; Vitamins

Topics: Barbiturates; Humans; Liver; Liver Diseases; Thiopental

Topics: Barbiturates; Humans; Liver Diseases; Stupor; Thiopental

Topics: Choline; Chronic Disease; Hypnotics and Sedatives; Liver Diseases; Methionine; Thiopental

Topics: Abdominal Injuries; Barbital; Health Services; Liver; Liver Diseases; Thiopental

Topics: Humans; Liver; Liver Diseases; Male; Thiopental

Topics: Anesthesia; Anesthesiology; Barbital; Liver Diseases; Sodium; Thiopental