thiopental and Nausea

Middle ear surgery is associated with a high incidence of emetic sequelae and propofol has been reported to have antiemetic activity in subhypnotic doses.. In a double-blind, randomized study, the patients received either thiopentone 1.0 mg.kg-1 (n = 26) or 0.5 mg.kg-1 propofol (n = 26) at the end of middle ear surgery under isoflurane-N2O-fentanyl-vecuronium anaesthesia. Trained nurses, unaware of the group assignment, assessed postoperative nausea, retching and vomiting up to 24 h after the end of anaesthesia. Droperidol 10 micrograms.kg-1 was used as a "rescue" antiemetic.. The main result was that the patient in the propofol group did not suffer from retching and vomiting (R&V) during the first 6 h, whereas these symptoms occurred in 46% (P < 0.001) of the patients in the thiopentone group. The patients in the propofol group needed significantly less droperidol during the first 24 h (mean number of doses 0.39 +/- 0.57 (SD)) than the patients in the thiopentone group (1.35 +/- 1.47, P < 0.005). Treatment with propofol was a predictor for lowered incidence of R&V, as well as male gender and negative history of motion sickness.. Propofol at a subhypnotic dose of 0.5 mg.kg-1 provides prophylaxis against retching and vomiting for the first 6 h postoperatively after middle ear surgery. The incidence of nausea was not reduced by propofol.

Topics: Adult; Aged; Antiemetics; Double-Blind Method; Ear, Middle; Female; Humans; Male; Middle Aged; Nausea; Postoperative Complications; Propofol; Thiopental; Vomiting

In two consecutive, randomized, double-blind studies the effect of ondansetron on the time to induction of anaesthesia with propofol and, subsequently, thiopentone was assessed. In each study 40 patients received either ondansetron 8 mg or placebo immediately before induction of anaesthesia with a standardized dose of propofol (2.5 mg kg-1) or thiopentone (5 mg kg-1). Times to induction of anaesthesia were determined by assessing loss of verbal response, motor power and eyelash reflex. There was no difference in either study in times to induction of anaesthesia between immediate pre-treatment with ondansetron or placebo. Side effects were minor and of similar incidence in the ondansetron and placebo groups.

Topics: Adult; Anesthesia, General; Anesthetics, Intravenous; Antiemetics; Double-Blind Method; Female; Humans; Middle Aged; Nausea; Ondansetron; Propofol; Thiopental; Time Factors; Vomiting

Postoperative nausea and vomiting (PONV) frequently follows prominent ear correction under general anaesthesia in children. In a prospective, single-blind study, we compared the incidence of PONV after propofol infusion anaesthesia with that following thiopentone induction and isoflurane maintenance in 30 children aged from four to 14 years randomly allocated to one of two groups. All the children were mechanically ventilated. Anaesthesia was supplemented in both groups with nitrous oxide and infiltration of the ears using a mixture of bupivacaine, adrenaline, and hyaluronidase. One child receiving propofol (group P) complained of nausea, compared with eight receiving thiopentone/ isoflurane, (group T) (P = 0.005), while three children in group P and ten in group T vomited before hospital discharge, (P = 0.01). Eight children in group P were considered to be fit for discharge on the day of surgery as against four in group T, (not significant). Only four out of twelve children receiving opioid analgesia vomited.

Topics: Adolescent; Anesthesia Recovery Period; Anesthesia, General; Anesthetics, Combined; Anesthetics, Inhalation; Anesthetics, Intravenous; Child; Child, Preschool; Ear, External; Humans; Isoflurane; Nausea; Pain, Postoperative; Propofol; Prospective Studies; Single-Blind Method; Thiopental; Vomiting

The postoperative antiemetic effect of total intravenous anesthesia with propofol and fentanyl was evaluated in 40 patients for laparoscopic cholecystectomy. Patients were divided into 2 groups. In group P, anesthesia was induced with intravenous fentanyl 0.1 mg and propofol 2 mg.kg-1 and maintained with continuous infusion of propofol. In group I, anesthesia was induced with intravenous thiopental 5 mg.kg-1 and maintained with nitrous oxide 60% in oxygen and isoflurane. Post-operative nausea and vomiting were recorded for 8 h after surgery. Nausea scores (range 1-4) were significantly lower in group P as compared with group I at 0 h after surgery, but no difference between the groups at 2 h, 4 h, 8 h after surgery. No significant differences were found in the incidence of vomiting between the groups. These results suggest that total intravenous anesthesia with propofol and fentanyl is superior to inhalational anesthesia with nitrous oxide and isoflurane in postoperative nausea. This antiemetic effect is, however, limited in the early period after anesthesia.

Topics: Aged; Anesthesia, Inhalation; Anesthesia, Intravenous; Anesthetics, Combined; Anesthetics, Inhalation; Anesthetics, Intravenous; Cholecystectomy, Laparoscopic; Female; Fentanyl; Humans; Isoflurane; Male; Middle Aged; Nausea; Nitrous Oxide; Postoperative Complications; Propofol; Thiopental; Time Factors; Vomiting

Sixty ASA I and II patients scheduled for laparoscopic cholecystectomy or inguinal herniotomy were randomly assigned to one of two groups: Group one (n = 30): induction with thiopentone 4-6 mg kg-1, fentanyl 2 micrograms kg-1, pancuronium 0.03 mg kg-1, and succinylcholine 1 mg kg-1, maintainance with halothane (0.8-1.5%), and N2O in O2 (FiO2 = 0.33). Group two (n = 30): induction with propofol 2-3 mg kg-1, fentanyl 2 micrograms kg-1, pancuronium 0.03 mg kg-1, and succinylcholine 1 mg kg-1, maintainance with propofol 6-10 mg kg-1 h-1, and O2 in N2 (FiO2:0.33). Seven of the patients experienced nausea in each group with group one having higher emetic scores. Six patients in group one vomited compared to none in group two (P < 0.05). The overall incidence of emetic sequelae (nausea or vomiting) was 43% in group one and 23% in group two (P = 0.17). Patients with propofol anaesthesia had lower emetic scores and higher recovery scores compared with those after thiopentone/halothane anaesthesia.

Topics: Adult; Aged; Anesthesia; Anesthetics; Female; Halothane; Humans; Laparoscopy; Male; Middle Aged; Nausea; Postoperative Complications; Propofol; Thiopental; Vomiting

The present prospective study investigates the impact of a standardized technique of spinal and general anaesthesia on the incidence and consequences of postanaesthetic complaints dependent on age and sex of patients.. 433 orthopaedic patients underwent lower limb surgery in spinal (group 1) or general (group 2) anaesthesia. Spinal anaesthesia was performed with 0.5% hyperbaric bupivacaine using a 26-gauge Quincke needle. General anaesthesia was induced with i.v. injection of thiopentone, fentanyl and atracurium and maintained with 65% nitrous oxide and 1-1.5 Vol% isoflurane in oxygen. On postoperative day 4, patients were interviewed for onset and duration of postoperative complaints.. The overall incidence of nausea/vomiting (P = 0.025) and sore throat (P = 0.0001) was higher in group 2. In addition, nausea/vomiting was higher in patients between 20 and 60 years in group 2 compared with group 1. While the incidence of urinary dysfunction was higher in men after spinal (P = 0.04), nausea/vomiting was more frequent in women after general anaesthesia (P = 0.008). Analgetic requirements (P = 0.013), time of postoperative surveillance (P = 0.042) and frequency of treatment of postoperative complaints (P = 0.0001) was higher in group 2.. Spinal anaesthesia was associated with a lower incidence of postoperative complaints and treatments and a shorter surveillance compared to general anaesthesia. Specific complications related to spinal anaesthesia did not depend on age or sex and may allow for recommendation of this technique even in younger and female patients undergoing orthopaedic surgery.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, General; Anesthesia, Spinal; Anesthetics, Inhalation; Anesthetics, Intravenous; Female; Humans; Isoflurane; Leg; Low Back Pain; Male; Middle Aged; Nausea; Orthopedics; Pharyngitis; Postoperative Complications; Prospective Studies; Thiopental; Urination Disorders; Vomiting

To determine whether a totally intravenous technique with propofol and fentanyl is superior to isoflurane anesthesia in patients undergoing middle ear surgery.. Prospective randomized study.. Inpatient otolaryngology service at a university medical center.. Physical status 1 and 2 nonobese patients with no significant history of diabetes, chronic cholecystitis, neuropathy, or neuromuscular disorders that could produce delayed gastric emptying. One hundred two patients were admitted to the study and randomly divided into three equal groups.. Intravenous thiopental, 5 mg/kg, was administered for induction of anesthesia followed by 60% air/O2 with isoflurane, 1% to 2% end tidal, for maintenance anesthesia (group 1). The same anesthetic with the addition of droperidol, 25 micrograms/kg, was given after induction (group 2). Propofol, 2 mg/kg, was administered intravenously for induction of anesthesia and followed by propofol, 50 to 250 micrograms/kg/min, for maintenance anesthesia. All groups received fentanyl, 3 micrograms/kg intravenously, after induction.. Surgical duration, induction, maintenance, and total anesthesia times were recorded together with eye opening and extubation. Intergroup comparisons of postoperative nausea, vomiting, and pain, and recovery scores, we made by use of the Steward system. Patients receiving propofol, compared with the isoflurane-only group, had significantly less nausea (4/34 vs 12/34 patients, respectively; p < 0.05) and as vomiting (2/34 vs 8/34 patients, respectively; p < 0.05). Immediate recovery scores were significantly better for propofol compared with the isoflurane-droperidol group. Recovery scores at 30 minutes were also faster with propofol compared with isoflurane or isoflurane-droperidol (5.7 +/- 0.1 vs 5.1 +/- 0.2 and 5.2 +/- 0.2; p < 0.05).

Topics: Adult; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia, Intravenous; Droperidol; Ear, Middle; Female; Fentanyl; Humans; Isoflurane; Male; Middle Aged; Nausea; Pain, Postoperative; Postoperative Complications; Propofol; Prospective Studies; Thiopental; Vomiting

The purpose of this study was to determine the rate and quality of recovery when general anaesthesia was induced with a mixture of thiopentone and propofol, compared with thiopentone or propofol alone. Sixty ASA class I and II women scheduled for out-patient laparoscopic surgery underwent induction of anaesthesia with either (i) thiopentone, (ii) propofol, or (iii) a mixture of the two, in a randomized, double-blind fashion. Anaesthesia was then maintained using nitrous oxide, isoflurane and fentanyl. A psychometric test was administered before and after surgery, and the time taken to reach a series of recovery milestones was noted. Patients were discharged as soon as they were ambulant and had satisfactory control of pain and nausea with oral agents. They were telephoned at 24-48 hr later, and asked to rate their experience of a list of side effects on an ordinal scale. Patient groups were demographically comparable and underwent surgery of the same duration. Those receiving thiopentone were discharged after a mean time of 3 hr 25 +/- 58 min (SD). The corresponding figures for propofol and the thiopentone/propofol mixture were 2 hr 40 min (+/- 49) and 2 hr 48 min (+/- 68) respectively. The recovery time between thiopentone and the other two regimes was different (P < 0.05). All three groups experienced equally frequent and severe nausea, headache, tiredness and other side effects during the next 24 hr. It is concluded that induction with a mixture of thiopentone and propofol leads to a similar rate and quality of recovery to that of propofol above.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Anesthesia Recovery Period; Anesthesia, Intravenous; Double-Blind Method; Drug Combinations; Fatigue; Female; Follow-Up Studies; Headache; Humans; Laparoscopy; Locomotion; Middle Aged; Nausea; Pain, Postoperative; Patient Discharge; Patient Satisfaction; Propofol; Psychomotor Performance; Thiopental

Postoperative recovery after induction with either propofol or thiopentone has been compared in forty ASA I unpremedicated day surgery patients undergoing surgical extraction of third molar teeth under relaxant general anaesthesia. Mean recovery times in the propofol group, required for patients to sit out of bed (44.8 minutes; SD 18.6) and meet discharge criteria (113.1 minutes; SD 34.5) were significantly (P less than 0.05) shorter than those in the thiopentone group (59.7 minutes; SD 21.4 and 133.5 minutes; SD 34.5). Fewer patients in the propofol group were treated in the recovery room for nausea and vomiting and the incidence of mild nausea not requiring treatment was less in the propofol group, but these differences were not statistically significant. Postoperative mental performance, measured by the FAST index, a new test of mental speed, was reduced on average by 1.7% of preoperative levels, during the recovery period tested, with no significant difference between the groups.

Topics: Adult; Ambulatory Surgical Procedures; Anesthesia Recovery Period; Anesthesia, Intravenous; Dizziness; Double-Blind Method; Female; Humans; Locomotion; Male; Mental Processes; Molar, Third; Nausea; Patient Discharge; Propofol; Thiopental; Tooth Extraction; Vomiting

Hemodynamic changes and side effects of anesthesia induction with etomidate or thiopental were evaluated in 83 ASA class I or II patients. Patients were randomly assigned to one of 12 groups according to pretreatment drug (fentanyl, 100 micrograms, or normal saline intravenously), induction agent (etomidate, 0.4 mg/kg, or thiopental, 4 mg/kg), and maintenance anesthetic technique (isoflurane-oxygen, isoflurane-nitrous oxide-oxygen, or fentanyl-nitrous oxide-oxygen). The purpose of this experiment, of factorial design, was to evaluate the combined effects of two or more experimental variables used simultaneously and to observe interaction effects. There were significant increases in heart rate in all groups, especially after tracheal intubation. These increases were attenuated but not eliminated by fentanyl pretreatment. Systolic arterial blood pressure increased significantly after intubation and was not affected either by fentanyl pretreatment or by the induction agent. Patients in whom anesthesia was induced with etomidate had a greater incidence of pain on injection and myoclonus and a lesser incidence of apnea than patients in whom anesthesia was induced with thiopental. Fentanyl pretreatment significantly decreased the incidence of pain on injection and myoclonus, but it increased the incidence of apnea when anesthesia was induced with etomidate. The incidence of postoperative nausea and vomiting was similar after thiopental and etomidate and was unaffected by fentanyl pretreatment. (ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Analysis of Variance; Anesthesia, General; Anesthesia, Inhalation; Anesthesia, Intravenous; Apnea; Blood Pressure; Etomidate; Female; Fentanyl; Heart Rate; Humans; Imidazoles; Male; Middle Aged; Myoclonus; Nausea; Nitrous Oxide; Pain; Preanesthetic Medication; Random Allocation; Thiopental

Sixty-two postoperative patients were admitted to a double-blind study to compare the therapeutic effectiveness of a single intramuscular injection of 1 mg of haloperidol with that of a placebo for the relief of vomiting and nausea following surgical procedures. Significantly fewer patients continued to vomit or experience nausea in the haloperidol-treatment group than in the placebo-treatment group. No statistically or clinically significant change in vital signs occurred in the haloperidol-treatment group. No serious side effect occurred in either group.

Topics: Abdomen; Adolescent; Adult; Aged; Anesthesia, Inhalation; Anesthetics; Clinical Trials as Topic; Colorado; Cyclopropanes; Female; Haloperidol; Humans; Injections, Intramuscular; Male; Middle Aged; Nausea; Nitrous Oxide; Oxygen; Placebos; Postoperative Complications; Thiopental; Vagina; Vomiting

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

Topics: Adult; Amides; Antiemetics; Benzoates; Blood Pressure; Cyclopropanes; Female; Humans; Injections, Intramuscular; Middle Aged; Morphine; Nausea; Oxygen; Postoperative Complications; Preanesthetic Medication; Pulse; Thiopental; Vomiting

Topics: Adult; Anesthesia, Inhalation; Atropine; Curettage; Dilatation; Ethyl Ethers; Female; Humans; Hysterectomy; Middle Aged; Nausea; Nitrous Oxide; Oxygen; Thiopental; Vomiting

Postoperative nausea and vomiting (PONV) has many causes, including anaesthetic drugs. Choice of induction agent may affect the incidence of PONV, though the evidence is conflicting. We have analysed our database of outcome after surgery. Data on 4173 patients were analysed using multivariate logistic regression, with an overall incidence of PONV 21.3%. Propofol, when compared to thiopentone for induction of anaesthesia, resulted in an 18% reduction in PONV (OR = 0.82, P = 0.03). The likely postoperative benefits of propofol may outweigh concerns about its additional cost.

Topics: Adult; Aged; Anesthesia, Intravenous; Anesthetics, Intravenous; Female; Humans; Incidence; Male; Middle Aged; Nausea; Postoperative Complications; Propofol; Thiopental; Vomiting

To determine the efficacy and safety of rectal thiopental sodium as a sedation agent for pediatric imaging.. Four hundred sixty-two infants and children were sedated with rectal thiopental sodium for MR, CT, or nuclear imaging in 1992 and 1993. Patients received screening histories and physical examinations before sedation, and parents gave informed consent. Sedated patients were monitored by pulse oximetry and direct observation. Twenty-four-hour telephone follow-up to assess delayed side effects was performed successfully in 325 patients.. Examinations were successfully completed in 96% of patients. The average time from drug administration to sedation was 12.2 minutes. The average time from sedation to discharge from radiology was 71.1 minutes. Eleven percent of patients had desaturation below the pulse oximetric baseline easily treated with oxygen and head positioning. Twenty-four-hour telephone follow-up in 325 patients revealed a 34% incidence of minor rectal irritation and diarrhea, sleepiness, nausea and vomiting, or ataxia.. Rectal thiopental sodium is a safe and effective drug for pediatric sedation.

Topics: Administration, Rectal; Ataxia; Child; Child, Preschool; Conscious Sedation; Diagnostic Imaging; Diarrhea; Follow-Up Studies; Head; Humans; Infant; Magnetic Resonance Imaging; Nausea; Oximetry; Oxygen Inhalation Therapy; Patient Discharge; Radionuclide Imaging; Sleep Stages; Thiopental; Time Factors; Tomography, X-Ray Computed; Vomiting

A thiopental test 2 weeks after insertion of intracranial electrodes may be used to evaluate patients with refractory epilepsy for surgical therapy. Barbiturates normally produce beta activity on the electroencephalogram. The absence of this response in a monitored brain region implies focal cerebral dysfunction. We describe a technique used to perform this test and the resultant morbidity. The thiopental test consists of intravenous injection of thiopental, 25 mg, every 30 s until either corneal reflexes are abolished, 1,000 mg of thiopental has been administered, or adverse events occur. In children, the dose is adjusted to approximately 0.3 mg/kg of thiopental every 20 s. A retrospective chart review was performed on 104 patients who underwent thiopental tests at the University of Pittsburgh Epilepsy Center. Records were systematically reviewed for thiopental dose, mean arterial blood pressure, heart rate, oxygen saturation in arterial blood, time to responsivity, need for airway intervention, and occurrence of nausea or vomiting. Thirty-six patients developed upper airway obstruction which required jaw lift maneuver, six patients were given 1,000 mg of thiopental without loss of corneal reflexes, and one patient briefly sustained an arterial saturation of 67%. Five patients exhibited electrographic seizures with clinical seizures evident in two patients. No permanent effects were evident in any patient as a consequence of the test. We conclude, with appropriate monitoring and personnel, that the thiopental test, as described, can be performed safely with acceptable morbidity.

Topics: Adolescent; Adult; Epilepsy; Evaluation Studies as Topic; Female; Hemodynamics; Humans; Male; Middle Aged; Nausea; Oxygen; Retrospective Studies; Thiopental; Vomiting

Topics: Anesthetics; Arrhythmias, Cardiac; Blood Pressure; Child; Drainage; Drug Combinations; Ear, Middle; Female; Heart Rate; Humans; Hydroxysteroids; Male; Nausea; Pediatrics; Preanesthetic Medication; Pregnanediones; Pulse; Reflex; Respiration; Thiopental; Tympanic Membrane; Vomiting

Topics: Acidosis; Acute Kidney Injury; Anemia; Anesthesia; Anesthesia, Epidural; Anesthesia, Spinal; Antihypertensive Agents; Arrhythmias, Cardiac; Heart Failure; Hepatitis; Humans; Hyperkalemia; Hypertension; Hypocalcemia; Hyponatremia; Kidney Failure, Chronic; Nausea; Preanesthetic Medication; Seizures; Thiopental; Uremia; Vomiting

Topics: Amnesia; Diazepam; Female; Humans; Hysterectomy; Injections, Intravenous; Nausea; Preanesthetic Medication; Thiopental; Vomiting

Topics: Abortion, Spontaneous; Adolescent; Adult; Atropine; Cervix Uteri; Curettage; Cyclopropanes; Dilatation; Ergonovine; Female; Humans; Meperidine; Middle Aged; Morphine; Nausea; Nitrous Oxide; Oxygen; Oxytocin; Postoperative Complications; Preanesthetic Medication; Pregnancy; Thiopental; Uterine Hemorrhage; Uterus; Vomiting

Topics: Anesthesia, Intravenous; Anesthetics; Humans; Methohexital; Nausea; Thiopental; Tremor; Vomiting

Topics: Anesthesia; Anesthesia, General; Anesthesia, Spinal; Bronchitis; Cyclopropanes; Ether; Halothane; Hernia, Inguinal; Meperidine; Muscle Relaxants, Central; Nausea; New York; Nitrous Oxide; Pneumonia; Postoperative Complications; Respiratory Tract Infections; Surgical Procedures, Operative; Thiopental; Toxicology; Urinary Catheterization; Vomiting