thiopental and Neoplasms

Four patients with advanced cancer were referred to the Pain Team because of refractory pain symptoms. They received intravenous barbiturates prior to death. All attempts at palliative treatment had been exhausted. The symptoms were described by patients and family as unendurable. After adding intravenous thiopental, relief and tranquility were achieved. All four patients died peacefully. The need to sedate to a state of unconsciousness or semi-consciousness to relieve symptoms in dying cancer patients is extremely rare. After all viable alternatives have been explored, titrated barbiturate infusion as an adjuvant may fill a void in the care of especially challenging patients as they approach death from terminal cancer.

Topics: Anesthetics, Intravenous; Female; Humans; Hypnotics and Sedatives; Infusions, Intravenous; Male; Middle Aged; Neoplasms; Palliative Care; Terminal Care; Thiopental

Four children ranging in age from 6-30 months were treated with twice-daily (BID) radiation therapy under general anesthesia with a 5-6 hr treatment interval. Anesthesia was accomplished with sodium thiopental administered intravenously (IV) by bolus injection. This as followed by continuous drip infusion of sodium thiopental in a few instances where more prolonged anesthesia was required. Children received an initial formula feeding 6 hr before their first treatment and were subsequently kept NPO (nothing by mouth) until they recovered from their second anesthesia. Recovery from thiopental was rapid and children were ready for a normal feeding within 1-1 1/2 hr of the second treatment. No parenteral feedings were required in any of these patients. Children maintained their weight during courses of radiation therapy which ranged between 19 and 43 elapsed days. There were no radiation-related treatment breaks. One child experienced two hypotensive episodes during anesthesia which responded rapidly to intravenous atropine. No other anesthetic complications occurred. This experience demonstrates that hyperfractionated radiation therapy can be safely delivered in infants requiring general anesthesia for immobilization. We feel that sodium thiopental is the anesthetic of choice in this setting because of the short duration of action and consequently rapid post-anesthesia recovery which makes it possible to achieve adequate nutrition with oral feedings alone.

Topics: Anesthesia, General; Cerebellar Neoplasms; Child, Preschool; Female; Humans; Infant; Male; Medulloblastoma; Neoplasms; Neuroblastoma; Radiotherapy Dosage; Rhabdomyosarcoma; Spinal Cord Neoplasms; Thiopental; Time Factors

The anaesthetic management of two patients with severe muscle weakness--one suffering from acute dermatomyositis, the other from acute polymyositis--is described. Both patients presented for surgery for malignancy. Anaesthesia was induced with etomidate in one, thiopentone in the other. Alfentanil was used for analgesia and atracurium for muscle paralysis in both. Neuromuscular blockade was monitored using a peripheral nerve stimulator and no problems were experienced. Recovery of neuromuscular transmission and ventilatory function after operation were normal.

Topics: Acute Disease; Aged; Alfentanil; Anesthesia, General; Atracurium; Dermatomyositis; Etomidate; Fentanyl; Humans; Male; Middle Aged; Myositis; Neoplasms; Preanesthetic Medication; Thiopental

Topics: Adult; Body Temperature; Brain; Electroencephalography; Female; Hot Temperature; Humans; Male; Middle Aged; Neoplasms; Thiopental

Topics: Adolescent; Adult; Aged; Anesthetics; Body Temperature; Body Temperature Regulation; Chemical and Drug Induced Liver Injury; Fentanyl; Fever; Heating; Humans; Middle Aged; Neoplasm Metastasis; Neoplasms; Pain; Thiopental

Topics: Age Factors; Anesthesia; Child, Preschool; Humans; Infant; Neoplasms; Thiopental

Some similarities have been found between the actions of anesthetics and freezing on biological membranes. Therefore, it has been thought that these agents could potentiate the destructive effect of cryosurgery. Experiments on cryopreservation of HeLa cells in vitro using three anesthetics--thiopental sodium, lignocaïne and CT 1341--indicate enhancement of "cryosensitivity". When using in vivo the same anesthetics injected in an experimental carcinoma (KDMC) of the Sprague-Dawley rat, cryosurgically treated, the results are: --no tumoricidal effect nor antitumoral activity of these agents when used alone,--the simultaneous use of anesthetics and cryosurgery gives better (but no significant results than cryosurgery alone,--the best agent in regard to this possible adjuvant effect seems to be thiopental sodium, it also facilitates tumoral dissemination. The authors conclude from these preliminary results that they need further experiments to assess this findings with smaller tumors, more numerous animals, same and others anesthetics at different concentrations. They attempt to define some caracteristics of potentiative agents during physical phase of cryodestruction.

Topics: Alfaxalone Alfadolone Mixture; Anesthetics; Animals; Cryosurgery; HeLa Cells; Lidocaine; Neoplasms; Neoplasms, Experimental; Rats; Thiopental

Topics: Adult; Aged; Anesthesia, Intravenous; Animals; Carcinoma, Hepatocellular; Female; Humans; In Vitro Techniques; Laryngeal Neoplasms; Liver Neoplasms; Male; Middle Aged; Neoplasms; Neoplasms, Experimental; Rats; Stomach Neoplasms; Thiopental

Topics: Adult; Aged; Anesthesia, General; Aortic Rupture; Curare; Esophageal and Gastric Varices; Female; Humans; Male; Middle Aged; Neoplasms; Nitrous Oxide; Postoperative Complications; Preanesthetic Medication; Succinylcholine; Thiopental

Topics: Anesthesia; Antineoplastic Agents; Chemotherapy, Cancer, Regional Perfusion; Ethers; Ethers, Cyclic; Head; Head and Neck Neoplasms; Humans; Neoplasms; Perfusion; Respiratory Insufficiency; Thiopental