thiopental and Multiple-Organ-Failure

To assess safety and efficacy of propofol and thiopental for refractory status epilepticus (RSE) in children, the authors reviewed 34 episodes of RSE. Thiopental was effective in most patients, but there were serious side effects. Propofol was used according to a strict protocol. It was effective in most patients, so that thiopental was not needed. Side effects were infrequent, of minor severity, and fully reversible. The authors suggest the use of propofol before thiopental.

Topics: Anticonvulsants; Child; Clinical Protocols; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Resistance; Humans; Hypertriglyceridemia; Liver Failure; Lung Diseases; Multiple Organ Failure; Propofol; Retrospective Studies; Rhabdomyolysis; Status Epilepticus; Thiopental; Treatment Outcome

We experienced a case of alachlor herbicide (Lasso) intoxication. A 57-year-old man was transported to our hospital by ambulance after ingesting 450 mL of Lasso. He was unconscious and had difficulty in breathing. Gastric lavage was performed after tracheal intubation and the patient was placed on mechanical ventilation. Activated charcoal and laxative were administrated. Even after admission, disturbance of consciousness persisted. He had liver and kidney disorders but these did not progress to multiple organ failure. He experienced convulsions from day 4 and was administered anticonvulsants. Convulsion was intractable and needed long-term treatment. His general condition improved until discharge. He was weaned from mechanical ventilation and recovered consciousness, but he still displayed tremors. The herbicide (Lasso) is a combination of alachlor and monochlorobenzene. Studies have shown that alachlor is neurotoxic and monochlorobenzene accumulates in the brain. In case of intoxication with the herbicide Lasso, treatment is required for ameliorating neurotoxic effects and intractable convulsion as well as liver and kidney disorders, gastrointestinal mucosal damage, hematopoietic disorder, and acute circulatory failure.

Topics: Acetamides; Anticonvulsants; Clonazepam; Gastric Lavage; Herbicides; Humans; Male; Middle Aged; Multiple Organ Failure; Respiration, Artificial; Seizures; Thiopental; Valproic Acid

Topics: Anesthesia, Intravenous; Anesthetics, Intravenous; Brain; Craniotomy; Dose-Response Relationship, Drug; Fatal Outcome; Humans; Infusions, Intravenous; Male; Middle Aged; Multiple Organ Failure; Propofol; Rhabdomyolysis; Shock, Cardiogenic; Status Epilepticus; Thiopental