thiopental and Pain

The physiology and pathology of different methods of capital punishment are described. Information about this physiology and pathology can be derived from observations on the condemned persons, postmortem examinations, physiological studies on animals undergoing similar procedures, and the literature on emergency medicine. It is difficult to know how much pain the person being executed feels or for how long, because many of the signs of pain are obscured by the procedure or by physical restraints, but one can identify those steps which are likely to be painful. The general view has been that most of the methods used are virtually painless, and lead to rapid dignified death. Evidence is presented which shows that, with the possible exception of intravenous injection, this view is almost certainly wrong.

Topics: Capital Punishment; Cause of Death; Female; Humans; Injections, Intravenous; Male; Pain; Pain Measurement; Pancuronium; Poisoning; Thiopental; Wounds and Injuries

Topics: Acute Disease; Anesthesia; Animals; Blood Circulation; Chronic Disease; Endorphins; Halothane; Humans; Ketamine; Naloxone; Pain; Receptors, Opioid; Shock; Sleep; Thiopental

Topics: Affective Symptoms; Akathisia, Drug-Induced; Alfaxalone Alfadolone Mixture; Anesthesia, Intravenous; Anesthetics; Drug Hypersensitivity; Hemodynamics; Humans; Pain; Propanidid; Respiration Disorders; Thiopental; Time Factors

Topics: Anesthesia, General; Cognition; Consciousness; Female; Humans; Male; Mastectomy; Memory; Middle Aged; Nitrous Oxide; Pain; Prospective Studies; Succinylcholine; Thiopental

A retrospective descriptive nonrandomized cohort study of 585 anesthesia cards of patients who had undergone planned laparoscopic cholecystectomy showed no effect of the patient age and sex on the length of post-anesthetic rehabilitation period. The doses of sodium thiopental, ketamine, and trimeperidine affect the length of these periods by no more than 12%. Further search for and studying of factors affecting the duration of post-anesthetic rehabilitation is required in order to improve the safety and adequacy of general anesthesia.

Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Anesthesia, General; Anesthetics, Intravenous; Cholecystectomy, Laparoscopic; Female; Humans; Ketamine; Male; Middle Aged; Pain; Postoperative Period; Promedol; Retrospective Studies; Sex Factors; Thiopental

In this prospective, randomized, double-blind, controlled trial, our primary objective was to assess the effect of a 3 : 1 mixture of propofol and thiopental in reducing pain on injection in children. Our hypothesis was that a 3 : 1 mixture of propofol and thiopental (treatment) would reduce the incidence of pain on injection to 20% compared to the expected incidence of 40% in the control group of an 11 : 1 mixture of propofol and 2% lidocaine.. Study subjects were patients 12-17 years old who were scheduled to undergo surgery and general anesthesia. Pain was assessed by a single-blinded observer present in the operating room. The major statistical method used in the analysis was multiple logistic regression.. Among the 164 children analyzed, 96 patients (58.5%) were male. The average age was 14.3 (sd = 1.65). The incidence of pain in the control group was 32.1% (26/81), compared to 25.3% (21/83) in the treatment group. The logistic regression analysis showed that there was not sufficient evidence that the treatment group was better than control group in reducing pain (P = 0.24). There were no significant differences in postoperative recovery time, nausea, vomiting, or blood pressure between the two groups (all P values >0.10).. There was not sufficient evidence to show that a 3 : 1 mixture of propofol and thiopental was better than an 11 : 1 volume admixture of propofol and lidocaine in reducing the incidence of pain on injection to 20%.

Topics: Adolescent; Age Factors; Algorithms; Anesthetics, Combined; Anesthetics, Intravenous; Blood Pressure; Child; Double-Blind Method; Female; Heart Rate; Humans; Hypnotics and Sedatives; Injections, Intravenous; Logistic Models; Male; Midazolam; Odds Ratio; Pain; Pain Measurement; Preanesthetic Medication; Propofol; Prospective Studies; Sample Size; Thiopental

The purpose of this study was to determine the effectiveness of antihistamine therapy for withdrawal movements caused by rocuronium injection. One hundred seventy one ASA I-II adults undergoing elective surgery were randomly assigned to one of two groups. Patients in the control group (Group C) were premedicated with 2 mL normal saline, and those in the antihistamine group (Group A) were pre-medicated with 2 mL (45.5 mg) pheniramine maleate. After the administration of thiopental sodium 5 mg/kg, rocuronium 0.6 mg/kg was injected. Withdrawal movements were assessed using a four-grade scale. The administration of antihistamine reveals lower grade of withdrawal movement after rocuronium injection.

Topics: Adult; Androstanols; Anesthetics, Intravenous; Double-Blind Method; Female; Histamine H1 Antagonists; Humans; Incidence; Injections, Intravenous; Male; Middle Aged; Movement; Neuromuscular Nondepolarizing Agents; Pain; Pain Measurement; Pheniramine; Rocuronium; Thiopental

To test whether rapid injection of rocuronium reduces withdrawal movement on injection.. Randomized, prospective trial.. Operating room in a university hospital.. 150 ASA physical status I and II patients aged 18 to 60 years, undergoing general anesthesia.. Patients were randomized to three groups. After undergoing anesthesia induction with thiopental sodium, then 5 seconds later receiving a rubber tourniquet applied to the mid-forearm to stop intravenous (IV) flow by gravity, the pretreatment drug was injected. The tourniquet was held for 15 seconds then released, and 1.0 mg/kg of 1% rocuronium was injected IV. Group C patients (n = 50) were pretreated with 0.1 mL/kg of 0.9% NaCl and then injected with rocuronium slowly within 10 seconds. Group L patients (n = 50) were pretreated with 0.1 mL/kg of preservative-free 1% lidocaine and then injected with rocuronium slowly within 10 seconds. Group R patients (n = 50) were pretreated with 0.1 mL/kg of 0.9% NaCl and then rapidly injected with rocuronium within approximately one second (as quickly as possible).. After injection of the patient with the study drug, a single anesthesiologist with no knowledge of the study protocol graded each patient's response as follows: 0 = no response; 1 = mild movement limited to the wrist only; 2 = moderate movement involving the elbow and shoulder; and 3 = severe movement involving more than one extremity.. Group C had the most intense and frequent withdrawal response. The frequency and intensity of withdrawal movement was significantly less in Groups L and R than Group C. No significant difference in withdrawal response between Groups L and R was noted.. Withdrawal response can be significantly reduced for rocuronium injection without lidocaine pretreatment, simply through rapid injection.

Topics: Adolescent; Adult; Androstanols; Anesthetics, Intravenous; Anesthetics, Local; Female; Hospitals, University; Humans; Injections, Intravenous; Lidocaine; Male; Middle Aged; Movement; Neuromuscular Nondepolarizing Agents; Pain; Prospective Studies; Rocuronium; Sodium Chloride; Thiopental; Tourniquets; Young Adult

Propofol, a commonly used anesthetic, often causes pain on injection. Several methods have been described to reduce this pain, however, complete inhibition has not been achieved. Our randomized, placebo controlled, double blind study has been conducted to compare the analgesic efficacy of iv pretreatment of ketamine, meperidine, thiopental, lidocaine to minimize the injection pain of propofol. 125 patients ASA I and II were randomly allocated into 5 groups and received. Group K, ketamine 0.4 mg/kg; Group T, thiopental 0.5 mg/kg; Group M, meperidine 0.5 [corrected] mg/kg; Group L, lidocaine 1 mg/kg; Group S, saline 3 ml. All pretreatment drugs were made into 4 ml solutions and were accompanied by manual venous occlusion for 1 min, followed by tourniquet release and slowly IV administration of propofol. Pain was assessed with a four point scale. All treatment groups had a significantly lower incidence of pain than placebo group (p <0.05). However, it has been observed that pretreatment with ketamine was the most effective in attenuating pain associated with propofol injection (p <0.05). For painless injection of propofol, routine pretreatment with ketamine 0.4 mg/kg along with venous occlusion is recommended.

Topics: Adult; Analgesics, Opioid; Anesthetics, Dissociative; Anesthetics, Intravenous; Anesthetics, Local; Blood Pressure; Double-Blind Method; Electrocardiography; Female; Heart Rate; Humans; Injections, Intravenous; Ketamine; Lidocaine; Male; Meperidine; Middle Aged; Pain; Pain Measurement; Propofol; Thiopental

To determine which technique prevents the withdrawal associated with rocuronium administration in adults and children.. Blinded, randomized, prospective trial.. This study was set at an inpatient anesthesia in a university teaching hospital.. 200 adult patients (aged 19-63 years) and 150 children (aged 2-9 years) undergoing elective surgery requiring endotracheal intubation.. Four groups in adult and 3 groups in children of 50 patients each were investigated. In adult study, control groups with free intravenous (IV) flow (C-F) or the occlusion of IV flow (C-O) received saline as the pretreatment of rocuronium; lidocaine groups with free IV flow (L-F) or the occlusion of IV flow (L-O) received lidocaine as the pretreatment of rocuronium, preceded by thiopental 5 seconds before. In children study, groups P and L received saline and lidocaine as the pretreatment of rocuronium, respectively, and group S received rocuronium mixed with sodium bicarbonate after the pretreatment of placebo preceded by thiopental.. The patient's response to rocuronium injection was graded using a 4-point scale. The pH and osmolality of treatment solution were measured. The incidence of no movement after rocuronium was 96% in L-O, 46% in L-F, 26% in C-O, and 18% in C-F in adult and 96% in S, 58% in L, and 8% in P in children.. Withdrawal after rocuronium can be eliminated by the pretreatment of lidocaine during the occlusion of the IV flow in adults and addition of sodium bicarbonate in children.

Topics: Adult; Age Factors; Androstanols; Anesthetics, Intravenous; Anesthetics, Local; Child; Child, Preschool; Female; Humans; Injections, Intravenous; Intubation, Intratracheal; Lidocaine; Male; Middle Aged; Movement; Neuromuscular Nondepolarizing Agents; Pain; Prospective Studies; Rocuronium; Sex Factors; Sodium Chloride; Substance Withdrawal Syndrome; Thiopental

We examined whether pretreatment with a small dose of thiopental was effective in reducing pain induced by the intravenous injection of rocuronium. Withdrawal movement was used to assess pain reduction. Ninety patients were randomly assigned to one of two groups: patients in the control group were pretreated with 2 mL saline, and those in the thiopental group were pretreated with 2 mL (50 mg) thiopental. Thiopental 5 mg/kg was injected intravenously. After a loss of consciousness, the upper arm was compressed with a rubber tourniquet, and the pretreatment drugs were administered. Thirty seconds later the tourniquet was removed and 0.6 mg/kg rocuronium was administered. Withdrawal movement was assessed using a four-grade scale: no movement, movement limited to the wrist, to the elbow or to the shoulder. The frequency of withdrawal movement in the group pretreated with thiopental was lower than in the control group (34 vs. 13, p < 0.05). We concluded that pretreatment with 2 mL (50 mg) thiopental is effective in reducing pain caused by the intravenous injection of rocuronium.

Topics: Adult; Androstanols; Anesthetics, Intravenous; Female; Humans; Injections, Intravenous; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Pain; Pain Measurement; Rocuronium; Thiopental

Propofol causes pain on IV injection in 28%-90% of patients. A number of techniques have been tried to minimize propofol-induced pain, with variable results. We compared the efficacy of pretreatment with thiopental 0.25 mg/kg and 0.5 mg/kg and lidocaine 40 mg after venous occlusion for prevention of propofol-induced pain. One-hundred-twenty-four adult patients, ASA physical status I-II, undergoing elective surgery were randomly assigned into 4 groups of 31 each. Group I received normal saline, group II received lidocaine 2% (40 mg), and groups III and IV received thiopental 0.25 mg/kg and 0.5 mg/kg, respectively. All pretreatment drugs were made in 2 mL and were accompanied by manual venous occlusion for 1 min. Propofol was administered after release of venous occlusion. Pain was assessed with a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain at the time of propofol injection. Twenty-four patients (77%) complained of pain in the group pretreated with normal saline as compared with 12 (39%), 10 (32%), and 1 (3%) in the groups pretreated with lidocaine 40 mg, thiopental 0.25 mg/kg, and thiopental 0.5 mg/kg, respectively (P < 0.05). Thiopental 0.5 mg/kg was the most effective treatment. We therefore suggest routine pretreatment with thiopental 0.5 mg/kg along with venous occlusion for 1 min for prevention of pain associated with propofol injection.. Pain associated with IV injection of propofol is seen in 28%-90% patients. Pretreatment with thiopental 0.25 mg/kg and 0.5 mg/kg after manual venous occlusion for 1 min effectively attenuated pain associated with propofol injection. Thiopental 0.5 mg/kg was the most effective in prevention of propofol pain and can be used routinely.

Topics: Adult; Anesthetics, Intravenous; Anesthetics, Local; Double-Blind Method; Female; Humans; Lidocaine; Male; Pain; Propofol; Prospective Studies; Thiopental

Propofol is one of the most frequently applied intravenous anesthetics for the induction of general anesthesia. However, pain on injection of this agent is a considerable problem in daily anesthesia practice because of its severity. Administration of lidocaine prior to propofol injection is a standard technique for reducing the pain on injection. However, this method provides insufficient pain relief. To evaluate whether pretreatment with an ultra-short acting barbiturate, thiopental, is more effective than with lidocaine, a randomized and single-blinded trial was conducted. Patients (20-65 years old, n = 137) were allocated into six groups, and applied with physiological saline, thiopental (25, 50, 75, or 100 mg), or lidocaine (40 mg) at 30 second prior to propofol injection (1 mg/kg, 1200 ml/h). The patient was interviewed about the degree of pain just after propofol was totally injected. Both thiopental (> or =25 mg) and lidocaine decreased the severity of pain in comparison with physiological saline as evaluated by a six-graded pain score. Lidocaine failed to influence the incidence of pain (from 86% to 55%), although thiopental significantly decreased it to 40% (25 mg), 21% (50 mg), 12% (50 mg), and 0% (100 mg), respectively. Thiopental (> or =50 mg) decreased both the severity and incidence of pain more effectively than lidocaine. A Hill plot analysis of these data, after rearrangement by patient's body weight, estimated that the half-effective dose (ED50) and the ED99 of this drug to block pain on injection of propofol were 0.6 and 1.4 mg/kg, respectively.

Topics: Adult; Aged; Anesthetics, Intravenous; Anesthetics, Local; Body Weight; Dose-Response Relationship, Drug; Humans; Hypnotics and Sedatives; Injections; Lidocaine; Middle Aged; Pain; Pain Measurement; Preanesthetic Medication; Propofol; Thiopental

To evaluate the incidence of pain on injection in children during anesthetic induction with a 3:1.2 volume admixture of 1% propofol and 2.5% thiopentone (P/T) compared to a 10:1 volume admixture of 1% propofol and 2% lidocaine (P/L).. After Ethics Committee approval and informed written parental consent, 127 children, aged one to ten years were studied and randomized into two groups; Group P/L received an induction with 5 mg x kg(-1) of 1% propofol and 1 mg x kg(-1) of lidocaine, Group P/T with 3 mg x kg(-1) of 1% propofol and 3 mg x kg(-1) of 2.5% thiopentone in a standardized fashion. A single, blinded observer scored pain behaviour defined as a motor response of the arm, a verbal complaint of pain, cry and/or one of three standardized facial expressions of pain.. The incidence of pain was 14% in the P/T group, compared to 35% in the P/L group (chi(2)(1) = 7.5, P = 0.006). Motor response was the most frequent pain response in the P/L group (68%).. The P/T admixture is a practical and efficacious alternative to P/L for reducing pain on induction in children. Further work to evaluate the optimum proportions and possible adverse effects of this admixture should be done.

Topics: Anesthetics, Intravenous; Child; Child, Preschool; Drug Combinations; Female; Humans; Infant; Injections, Intravenous; Male; Pain; Propofol; Single-Blind Method; Thiopental

Effective plasma concentrations of propofol, thiopentone and ketamine were determined at different endpoints in a study with randomized, crossover design in nine New Zealand White rabbits. A continuous infusion was used (30 ml/h) with concentrations of 10 mg/ml for propofol, 25 mg/ml for thiopentone and 20 mg/ml for ketamine. The endpoints were loss of the righting reflex, loss of purposeful reactions to tail clamping (as an example of a peripheral pain stimulus) or to intranostril insufflation of ammonia vapour (as an example of a central reflex stimulus), and the recovery of these reflexes and reactions. According to the ED50 values the potency ratios of propofol, thiopentone and ketamine were at the loss of righting reflex 1:1.8:1.2, at the loss of reaction to ammonia vapour 1:1.5:1.6, and at the loss of reaction to tail clamping 1:1.5:3.9, respectively. Recovery was significantly faster after propofol than after thiopentone and ketamine. Measuring the effective plasma concentrations of intravenous anaesthetics provides a method of relating dose to effect, but there still remains a variable gap between plasma concentration and effect.

Topics: Anesthetics, Intravenous; Animals; Central Nervous System; Ketamine; Pain; Posture; Propofol; Rabbits; Reflex; Thiopental

Propofol injection associated with a high incidence of pain is well known. Propofol and sodium thiopental mixture has recently been reported to be used for cost saving and able to reduce pain on injection.. This prospective, randomized, double blind trial was designed to compare the efficacy of different percentages of propofol and sodium thiopental mixture in minimizing propofol injection pain. 146 ASA class 1 patients were assigned to seven groups (pure propofol, pure sodium thiopental, and propofol premixed with 10%, 20%, 30%, 40%, and 50% of sodium thiopental). The intensity of pain was graded and recorded as severe, moderate, mild and no pain according to the response of the patients to the injection.. The intensity of injection pain was significantly greater for pure propofol than the others while it was not significantly different among the other groups in comparison.. Sodium thiopental, when added to propofol, can significantly reduce propofol injection pain. This attenuation effect was noted even with as low as 10 volume % of sodium thiopental.

Topics: Adult; Anesthetics, Intravenous; Double-Blind Method; Female; Hemodynamics; Humans; Injections, Intravenous; Male; Middle Aged; Pain; Propofol; Prospective Studies; Thiopental

This study examined some pharmacodynamic characteristics of two admixtures of propofol and thiopentone. Ninety unpremedicated ASA 1 or 2 patients were group-randomized to receive, in a double-blinded manner, one of the following mixtures for induction of anaesthesia: Group P50: propofol 1% 10 ml/thiopentone 2.5% 10 ml; Group P75: propofol 1% 15 ml/thiopentone 2.5% 5 ml; Group P100: propofol 1% 20 ml/lignocaine 1% 4 ml. An additional 30 randomized but unblinded patients from the same patient cohort received thiopentone 2.5% to provide predictive dose data for groups P50 and P75. Haemodynamic data were collected pre- and post-induction. The required induction dose of both mixtures of propofol and thiopentone found an additive rather than a synergistic interaction with no significant difference between predicted and observed dose. Thiopentone resulted in significantly more rapid induction of anaesthesia than propofol/lignocaine or propofol/thiopentone. The addition of thiopentone to propofol was found to be as efficacious as the mixing of lignocaine with propofol in reducing pain on injection. The fall in systolic blood pressure was significantly less in group P50 compared with groups P75 or P100. Admixture of thiopentone with propofol results in an additive hypnotic effect, a reduction in pain of injection (comparable with addition of lignocaine) and a reduced hypotensive response compared to propofol injection alone during induction.

Topics: Adolescent; Adult; Ambulatory Surgical Procedures; Anesthetics, Combined; Anesthetics, Intravenous; Anesthetics, Local; Blood Pressure; Dose-Response Relationship, Drug; Double-Blind Method; Drug Interactions; Female; Gynecologic Surgical Procedures; Humans; Injections, Intravenous; Lidocaine; Middle Aged; Pain; Pain Measurement; Propofol; Thiopental

To investigate the efficacy of a subhypnotic dose of propofol to treat vomiting in children after adenotonsillectomy.. Two hundred and fifty-two children, aged 2-12 yr, underwent a standardized anaesthetic opioid administration, and postoperative care after adenotonsillectomy, adenoidectomy or tonsillectomy. A prospective, double-blinded, placebo-controlled study was performed in 70 of the patients who retched or vomited after surgery and who had intravenous access. Patients were assigned randomly to receive either 0.2 mg.kg-1) propofol (n = 35), or placebo (intralipid 10%, n = 35).. The overall incidence of vomiting during the first 18-24 hr was 50%. Of those who had received propofol after the first episode of vomiting, 63% relapsed requiring a rescue antiemetic compared with 57% of those who had received intralipid (P = NS). Of the children who received propofol, 54% experienced pain on injection and 46% were mildly sedated compared with 3% and 11%, respectively, in the placebo group (P < 0.003).. We conclude that an intravenous bolus of 0.2 mg.kg-1 propofolis not effective in the treatment of postoperative vomiting in children after adenotonsillectomy when a standardized anaesthetic with thiopentone, halothane, nitrous oxide, and 1.5 mg.kg-1 codeine phosphate is used, but it does cause sedation and pain on injection.

Topics: Adenoidectomy; Analgesics, Opioid; Anesthetics, Inhalation; Anesthetics, Intravenous; Antiemetics; Child; Child, Preschool; Codeine; Double-Blind Method; Fat Emulsions, Intravenous; Halothane; Humans; Hypnotics and Sedatives; Incidence; Injections, Intravenous; Nitrous Oxide; Pain; Placebos; Postoperative Complications; Propofol; Prospective Studies; Recurrence; Thiopental; Tonsillectomy; Vomiting

Popular depolarising muscle relaxant, suxamethonium (succinylcholine chloride), produces fasciculation in group of muscles and 'after pain'. Mode of its action is neuromuscular blockage. It also may be associated with muscle fibre injury and altered membrane permeability. These may cause rise of serum K+ and creatinine phosphokinase (CPK) levels. But use of diazepam either during or as pretreatment may reduce the fasciculation, 'after pain' and rise of K+ and CPK levels. Present study was undertaken to show whether any correlation of the degree of fasciculation and postsuxamethonium myalgia is present or not and whether diazepam has any role in reducing muscle injury and in turn reducing the levels of serum K+ and CPK.

Topics: Adult; Anesthetics, Intravenous; Creatine Kinase; Diazepam; Drug Therapy, Combination; Female; Humans; Hyperkalemia; Male; Neuromuscular Depolarizing Agents; Pain; Postoperative Complications; Succinylcholine; Thiopental

We investigated hemodynamic changes, induction time and the incidence of pain after rapid induction of anesthesia with propofol (Group P) in comparison with those after induction with thiopental (Group B). Anesthesia was induced with propofol 2.5 mg.kg-1 in Group P and thiopental 5 mg.kg-1 in Group B taking 20 seconds. When verbal response disappeared, tracheal intubation was performed with suxamethonium 1.2 mg.kg-1. The incidence of pain on injection, time from the start of injection of the drug to the disappearance of verbal response (induction time), blood pressure, heart rate, and rate pressure product (RPP) were monitored. The pain on injection was seen in 6 of 30 patients in Group P. This was significantly larger compared with 3 patients in Group B. The induction time was not different between the two groups. One minute after intubation, blood pressure, heart rate and RPP were significantly higher compared with those before induction in Group B. These were also significantly higher than those in Group P. Therefore, rapid induction with propofol is more useful compared with that with thiopental.

Topics: Adult; Anesthesia, Intravenous; Anesthetics, Intravenous; Female; Hemodynamics; Humans; Male; Middle Aged; Pain; Propofol; Reaction Time; Thiopental; Verbal Behavior

The aim of this study was to investigate pain perception during thiopentone or propofol infusions for sedation. Thirty ASA 1 or 2 patients received a two step infusion of either thiopentone (step 1: 1.25 mg.kg-1 followed by 2.5 mg.kg-1.h-1; step 2: 1.25 mg.kg-1 and 12.5 mg.kg-1.h-1; n = 15) or propofol (step 1: 0.5 mg.kg-1, 1 mg.kg-1.h-1; step 2: 0.5 mg.kg-1, 5 mg.kg-1.h-1; n = 15) for sedation. At control and 10 min after the start of each infusion dosage, reaction times and thermal pain detection thresholds were determined. We found no clinically or statistically significant depression of thermal pain detection thresholds during propofol or thiopentone infusions and these are, therefore, unlikely to be associated with clinically relevant hyperalgesia.

Topics: Adolescent; Adult; Aged; Depression, Chemical; Female; Hot Temperature; Humans; Hypnotics and Sedatives; Infusions, Intravenous; Male; Middle Aged; Pain; Pain Threshold; Propofol; Prospective Studies; Reaction Time; Thiopental

This study investigated propofol injection pain in patients undergoing ambulatory anaesthesia. In a randomized, double-blind trial, 90 women were allocated to receive one of three treatments prior to induction of anaesthesia with propofol. Patients in Group C received 2 ml normal saline, Group L, 2 ml, lidocaine 2% (40 mg) and Group T, 2 ml thiopentone 2.5% (50 mg). Venous discomfort was assessed with a visual analogue scale (VAS) 5-15 sec after commencing propofol administration using an infusion pump (rate 1000 micrograms.kg-1.min-1). Loss of consciousness occurred in 60-90 sec. Visual analogue scores (mean +/- SD) during induction were lower in Groups L (3.3 +/- 2.5) and T (4.1 +/- 2.7) than in Group C (5.6 +/- 2.3); P = 0.0031. The incidence of venous discomfort was lower in Group L (76.6%; P < 0.05) than in Group C (100%) but not different from Group T (90%). The VAS scores for recall of pain in the recovery room were correlated with the VAS scores during induction (r = 0.7045; P < 0.0001). Recovery room discharge times were similar: C (75.9 +/- 19.4 min); L 73.6 +/- 21.6 min); T (77.1 +/- 18.9 min). Assessing their overall satisfaction, 89.7% would choose propofol anaesthesia again. We conclude that lidocaine reduces the incidence and severity of propofol injection pain in ambulatory patients whereas thiopentone only reduces its severity.

Topics: Adolescent; Adult; Ambulatory Care; Analysis of Variance; Anesthesia, Intravenous; Anesthetics, Intravenous; Anesthetics, Local; Double-Blind Method; Female; Humans; Injections, Intravenous; Lidocaine; Middle Aged; Pain; Pain Measurement; Propofol; Thiopental

A controlled, double-blind study was performed to compare the prior administration of intravenous saline 4 ml (n = 36), lignocaine 20 mg (n = 36) or thiopentone 100 mg (n = 43) on the pain produced by intravenous injection of propofol. One hundred and fifteen ASA 1 or 2 patients scheduled for minor surgery were studied using a randomised, double-blind design. Thiopentone was more effective than lignocaine in reducing the incidence of propofol injection pain (p < 0.03).

Topics: Adolescent; Adult; Aged; Double-Blind Method; Female; Humans; Injections, Intravenous; Lidocaine; Male; Middle Aged; Pain; Premedication; Propofol; Thiopental

A double-blind, randomised, controlled study was undertaken to investigate the effects on injection pain and excitatory phenomena of adding thiopentone to methohexitone. One hundred and twenty unpremedicated, day-case patients received one of four induction regimens: unmodified 1% methohexitone, or a mixture of 2.5% thiopentone and 1% methohexitone in ratios of 1:1, 1:3 or 1:9 by volume. The addition of one part of thiopentone to three parts of methohexitone produced a mixture which significantly reduced the occurrence of pain and discomfort compared with methohexitone alone from 67% to 13% (p < 0.01) and reduced the occurrence of excitatory effects from 50% to 13% (p < 0.01).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia, Intravenous; Female; Hiccup; Humans; Intraoperative Complications; Laryngismus; Male; Methohexital; Middle Aged; Muscle Contraction; Pain; Thiopental

We conducted a prospective, randomised single-blind study in 48 adult women undergoing laparoscopic gynaecological surgery to assess the incidence of suxamethonium-induced myalgia. Anaesthesia was induced with either thiopentone or propofol. All other aspects of clinical care were standardised between the groups. The propofol group had a significantly lower incidence of suxamethonium myalgia (19%) compared with the thiopentone group (63%) (P < 0.05). The mechanism of this effect is not understood.

Topics: Adolescent; Adult; Anesthesia, Intravenous; Female; Genitalia, Female; Humans; Incidence; Laparoscopy; Middle Aged; Muscular Diseases; Pain; Pain Measurement; Propofol; Prospective Studies; Single-Blind Method; Succinylcholine; Thiopental

Subhypnotic doses of thiopentone are considered to have a hyperalgesic effect, while propofol has a hypoalgesic effect. We investigated the effect of these drugs on the nociceptive system by measuring the pain threshold to laser stimulation and the pain evoked potential (power and latency). Nineteen patients (ASA group I) participated. Twelve patients received thiopentone 0.5 mg kg-1 and propofol 0.25 mg kg-1 in random order separated by an interval of 14 h, and seven patients received saline. Immediately after the injection of both agents, the pain threshold was increased significantly (P less than 0.001) and the amplitude of the evoked potential was reduced significantly (P less than 0.05), while the latency of the evoked potential remained constant. It is concluded that, in subhypnotic doses, both thiopentone and propofol decrease the acute pain evoked by argon laser stimulation.

Topics: Acute Disease; Adult; Female; Humans; Lasers; Male; Middle Aged; Pain; Propofol; Thiopental

The characteristics of three combinations of thiopentone and etomidate [in the ratios of thiopentone (mg):etomidate (mg) of 5:1, 13:1 and 25:1] have been compared with the individual agents alone for the induction of anaesthesia. The incidence of pain on injection and abnormal movements was less with the combination containing the highest ratio of thiopentone to etomidate, when compared to etomidate alone. The mixtures did not otherwise confer any advantages over the individual agents.

Topics: Adult; Anesthesia; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia, Intravenous; Blood Pressure; Etomidate; Female; Heart Rate; Humans; Male; Movement; Nitrous Oxide; Pain; Thiopental

A double-blind study was conducted in 52 patients who received a total of 180 electroconvulsive therapy treatments. Patients were allocated randomly to receive doses of 15 mg, 25 mg or 50 mg of suxamethonium. Those who received suxamethonium 50 mg took significantly longer to breathe again compared with patients who received the lower doses, and were significantly more likely to have a very well modified convulsion than patients who received suxamethonium 15 mg. There were no differences among the groups in the incidences of muscle pains after treatment. We conclude that all three doses were acceptable; however, a dose of 25 mg had practical advantages over 50 mg and theoretical advantages over 15 mg.

Topics: Adult; Aged; Dose-Response Relationship, Drug; Electroconvulsive Therapy; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Random Allocation; Respiration; Succinylcholine; Thiopental; Time Factors

In a randomized open study, 120 healthy female patients were included. For short gynaecological procedures they were anaesthetized with either propofol 2.5 mg X kg-1 (n = 60) or thiopentone 5 mg X kg-1 (n = 60) in combination with nitrous oxide/oxygen (67%/33%). Supplementary doses of propofol (10-20 mg) or thiopentone (25-50 mg) were given when necessary during the procedure. Induction characteristics for propofol and thiopentone 1 min after start of induction were similar. Propofol seemed to have a more depressant effect than thiopentone on the circulatory response to anaesthesia. Recovery times from the end of the operative procedure until the patients opened their eyes on command and were orientated were shorter in the propofol patients compared to the thiopentone patients. In the propofol group, patients recalled discomfort on injection more often than patients anaesthetized with thiopentone. Otherwise, the side-effects were similar in both groups. We conclude that propofol is similar to thiopentone in its anaesthetic qualities during induction and maintenance of short anaesthetic procedures. Propofol was associated with a more rapid emergence from anaesthesia than thiopentone.

Topics: Anesthesia, Intravenous; Anesthetics; Arrhythmias, Cardiac; Dilatation and Curettage; Female; Hemodynamics; Humans; Pain; Phenols; Propofol; Thiopental

The induction characteristics of propofol 2.0-2.5 mg kg-1 were compared with those of thiopentone 4-5 mg kg-1 in 60 fit children aged between 3 and 16 yr. All patients received i.m. premedication with papaveretum 0.4 mg kg-1 (maximum dose 15 mg) and hyoscine 0.008 mg kg-1 (maximum dose 0.3 mg). Seven children (24%) complained of pain after injection with propofol, compared with three (10%) after thiopentone. No child in either group complained of severe pain. Excitatory effects were observed in 10 children (33%) receiving propofol as opposed to five children (16%) after thiopentone, but these were transient and minor and all occurred after completion of injection. Apnoea lasting longer than 30 s occurred in only four children (13%) in each group despite the use of opioid premedication. The mean duration of apnoea was similar in both groups. Propofol caused greater decreases in arterial pressures (systolic, diastolic, mean) than thiopentone, but only the difference in systolic arterial pressure achieved significance. There was a significant difference in heart rate, which did not change after propofol, but increased with thiopentone. The overall quality of induction was assessed as being good in all children receiving thiopentone compared with 20 (66%) of those receiving propofol.

Topics: Adolescent; Anesthesia, Intravenous; Anesthetics; Apnea; Blood Pressure; Child; Child, Preschool; Depression, Chemical; Female; Heart Rate; Humans; Intraoperative Complications; Male; Pain; Phenols; Propofol; Thiopental

Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. In the general anaesthesia group, there was a rise in either systolic or diastolic arterial pressure of over 30% of the control value in 8/15 patients. In the spinal anaesthesia patients, there was a transient rise above 30% in only one patient out of 15 and no rise in the 15 epidural group patients. On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated.

Topics: Adult; Anesthesia, Epidural; Anesthesia, General; Anesthesia, Spinal; Blood Pressure; Bupivacaine; Central Venous Pressure; Electrocardiography; Female; Fentanyl; Heart Rate; Hemodynamics; Humans; Male; Middle Aged; Nitrous Oxide; Orthopedics; Pain; Random Allocation; Thigh; Thiopental; Time Factors; Tourniquets

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

The frequency of local venous reactions after the injection i.v. of etomidate or thiopentone was studied in 61 patients undergoing surgery for prolapsed lumbar disc. Of the patients who received etomidate, 24% developed thrombophlebitis in the period after operation (up to 14 days). Of the patients who received thiopentone, 4% developed thrombophlebitis in the period after operation. Pain on injection occurred in 24% of the patients receiving etomidate, but there was no correlation between pain on injection and the subsequent thrombophlebitis.

Topics: Adult; Aged; Anesthesia, Intravenous; Etomidate; Female; Humans; Imidazoles; Male; Middle Aged; Pain; Thiopental; Thrombophlebitis

Topics: Adult; Anesthesia, Intravenous; Humans; Male; Middle Aged; Muscular Diseases; Pain; Succinylcholine; Thiopental

In 104 premedicated patients undergoing general surgery, anaesthesia was induced either with etomidate 0.3 mg kg-1 preceded by fentanyl 1.25 or 2.5 microgram kg-1 i.v.or diazepam 0.0625 or 0.125 mg kg-1 i.v., or with thiopentone preceded by fentanyl 1.25 microgram kg-1 i.v. Despite the use of fentanyl or diazepam, the frequency of pain on injection in patients receiving etomidate was between 32% and 53%, being rated as severe in 5-20% of patients. No pain was experienced by patients receiving thiopentone. The frequency of involuntary movement was 15-35% with etomidate and 15% with thiopentone. The frequency of both pain and involuntary muscle movements was least when fentanyl 2.5 microgram kg-1 preceded the administration of etomidate. There was no significant relationship between the pain and muscle movement; three of 10 patients given etomidate into a central vein had such movements.

Topics: Adult; Anesthesia, General; Diazepam; Etomidate; Fentanyl; Humans; Imidazoles; Middle Aged; Movement; Muscles; Pain; Thiopental

Topics: Humans; Methods; Muscles; Pain; Succinylcholine; Thiopental

Topics: Adult; Age Factors; Apnea; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Propanidid; Sex Factors; Succinylcholine; Thiopental

Past investigations assessing the effects of thiopental on pain are conflicting. Although several studies demonstrate hyperalgesia as a result of barbiturate administration, others show analgesia. Our objective was to assess the effects of an infusion of the GABAA agonist thiopental, compared with placebo, in healthy participants on two subjective experimental pain paradigms: noxious electrical stimulation and intradermal capsaicin.. For electrical stimulation, the milliamps required to achieve pain threshold and tolerance were recorded, and the percent change from baseline was determined for each infusion condition. In the intradermal capsaicin condition, the area of hyperalgesia was determined by von Frey technique pre- and postinfusion, and the percent change in the area of hyperalgesia was calculated.. Though thiopental infusion resulted in an increase in the electrical stimulation current required to elicit pain threshold or reach pain tolerance when compared with baseline, this finding was not statistically significant. In the intradermal capsaicin condition, there was a statistically significant difference in overall pre- and postinfusion pain interpretation, as measured by the McGill Pain Questionnaire (P < 0.05), but there was no significant difference in area of hyperalgesia.. In this human study of thiopental's effects on two experimental pain models, our results show that thiopental does not induce hyperalgesia.

Topics: Capsaicin; Double-Blind Method; Humans; Hyperalgesia; Laboratories; Pain; Thiopental

Procedural sedation and analgesia (PSA) is widely performed outside of the operating theater, often in emergency departments (EDs). The practice and safety of PSA in the ED in an aging society such as in Japan have not been well described. We aimed to characterize the practice pattern of PSA including indications, pharmacology and incidence of adverse events (AEs) in Japan.. We formed the Japanese Procedural Sedation and Analgesia Registry, a multicenter prospective observation registry of ED patients undergoing PSA. We included all patients who received PSA in the ED. PSA was defined as any systemic pharmacological intervention intended to facilitate a painful or uncomfortable procedure. The main variables in this study were patients' demographics, American Society of Anesthesiologists (ASA) physical status, indication of PSA, medication choices, and AEs. The primary outcome measure was overall AEs from PSA.. We enrolled 332 patients in four EDs during the 12-month period. The median age was 67 years (IQR, 46-78). In terms of ASA physical status, 79 (23.8%), 172 (51.8%), and 81 (24.4%) patients were class 1, 2, 3 or higher, respectively. The most common indication was cardioversion (44.0%). The most common sedative used was thiopental (38.9%), followed by midazolam (34.0%) and propofol (19.6%). Among all patients, 72 (21.7%, 95% confidence interval, 17-26) patients experienced one or more AEs. The most common AE was hypoxia (9.9%), followed by apnea (7.2%) and hypotension (3.5%). All of the AEs were transient and no patient had a serious AE.. In a multicenter prospective registry in Japan, PSA in the ED appears safe particularly since the patients who underwent PSA were older and had a higher risk profile compared to patients in previous studies in different countries.

Topics: Aged; Analgesia; Anesthesia; Conscious Sedation; Electric Countershock; Emergency Service, Hospital; Female; Humans; Hypnotics and Sedatives; Japan; Male; Midazolam; Middle Aged; Pain; Propofol; Thiopental

Spinal cord stimulation (SCS) is not typically recommended for the treatment of central poststroke pain (CPSP). We examined whether the pharmacological evaluation of CPSP is useful for selecting the candidates for SCS.. Changes in visual analog scale (VAS) scores for pain following pharmacological evaluation using morphine, thiopental, and ketamine were compared with those following SCS in 22 CPSP patients.. Twelve of the 22 (54.5%) patients in the ketamine test and thiopental test, and 5 (22.7%) of the 22 patients in the morphine test showed a more than 40% reduction in VAS score and were judged as "sensitive." Pain relief by SCS was estimated as excellent (≧60% VAS score reduction) in three patients, good (30-59% reduction) in nine patients, and fair (10-29% reduction) in seven patients 24 months after the start of SCS. The remaining 3 patients evaluated as having poor pain relief (<10% reduction) only underwent test SCS. VAS score reduction induced by SCS was more significant in ketamine-sensitive patients than in ketamine-resistant patients during the test SCS (p < 0.01, Mann-Whitney's U test) and 24 months after the start of chronic SCS (p < 0.05). However, there were no significant differences in results for thiopental-sensitive/thiopental-resistant or morphine-sensitive/morphine-resistant patients during the test SCS and 24 months after chronic SCS. Analysis of the rate of VAS score reduction by pharmacological evaluation and SCS showed significant correlations with the results of the ketamine test (r = 0.670, p = 0.001, Pearson's correlation coefficient test), but not with those of the thiopental (r = 0.291, p = 0.231) or morphine test (r = 0.327, p = 0.175).. We speculate that the pharmacological evaluation of CPSP patients can be a useful tool for selecting candidates for SCS.

Topics: Adult; Aged; Analgesics; Female; Humans; Ketamine; Male; Middle Aged; Morphine; Pain; Pain Management; Pain Measurement; Regression Analysis; Spinal Cord Stimulation; Stroke; Thiopental; Visual Analog Scale

Growing data support peripheral opioid antinociceptive effects, particularly in inflammatory pain models. Here, we examined the antinociceptive effects of subcutaneously administered, recently synthesized 14-O-methylmorphine-6-O-sulfate (14-O-MeM6SU) compared with morphine-6-O-sulfate (M6SU) in a rat model of inflammatory pain induced by an injection of complete Freund's adjuvant and in a mouse model of visceral pain evoked by acetic acid. Subcutaneous doses of 14-O-MeM6SU and M6SU up to 126 and 547 nmol/kg, respectively, produced significant and subcutaneous or intraplantar naloxone methiodide (NAL-M)-reversible antinociception in inflamed paws compared with noninflamed paws. Neither of these doses significantly affected thiobutabarbital-induced sleeping time or rat pulmonary parameters. However, the antinociceptive effects of higher doses were only partially reversed by NAL-M, indicating contribution of the central nervous system. In the mouse writhing test, 14-O-MeM6SU was more potent than M6SU after subcutaneous or intracerebroventricular injections. Both displayed high subcutaneous/intracerebroventricular ED50 ratios. The antinociceptive effects of subcutaneous 14-O-MeM6SU and M6SU up to 136 and 3043 nmol/kg, respectively, were fully antagonized by subcutaneous NAL-M. In addition, the test compounds inhibited mouse gastrointestinal transit in antinociceptive doses. Taken together, these findings suggest that systemic administration of the novel compound 14-O-MeM6SU similar to M6SU in specific dose ranges shows peripheral antinociception in rat and mouse inflammatory pain models without central adverse effects. These findings apply to male animals and must be confirmed in female animals. Therefore, titration of systemic doses of opioid compounds with limited access to the brain might offer peripheral antinociception of clinical importance.

Topics: Analgesics; Animals; Dose-Response Relationship, Drug; Drug Interactions; Female; Gastrointestinal Tract; Male; Mice; Morphine; Pain; Rats; Rats, Wistar; Respiration; Thiopental

We evaluated the effectiveness of intrathecal antagonists of α1- (WB4101) and α2- (idazoxan) adrenoceptors and serotonergic (methysergide), opioid (naloxone), muscarinic (atropine), GABA(A) (bicuculline) and GABA(B) (phaclofen) receptors in blocking 2- or 100-Hz electroacupuncture (EA)-induced analgesia (EAIA) in the rat tail-flick test. EA was applied bilaterally to the Zusanli and Sanyinjiao acupoints in lightly anesthetized rats. EA increased tail-flick latency, where the effect of 2-Hz EA lasted longer than that produced by 100-Hz EA. The 2-Hz EAIA was inhibited by naloxone or atropine, was less intense and shorter after WB4101 or idazoxan, and was shorter after methysergide, bicuculline, or phaclofen. The 100-Hz EAIA was less intense and shorter after naloxone and atropine, less intense and longer after phaclofen, shorter after methysergide or bicuculline, and remained unchanged after WB4101 or idazoxan. We postulate that the intensity of the effect of 2-Hz EA depends on noradrenergic descending mechanisms and involves spinal opioid and muscarinic mechanisms, whereas the duration of the effect depends on both noradrenergic and serotonergic descending mechanisms, and involves spinal GABAergic modulation. In contrast, the intensity of 100-Hz EAIA involves spinal muscarinic, opioid, and GABA(B) mechanisms, while the duration of the effects depends on spinal serotonergic, muscarinic, opioid, and GABA(A) mechanisms.. The results of this study indicate that 2- and 100-Hz EA induce analgesia in the rat tail-flick test activating different descending mechanisms at the spinal cord level that control the intensity and duration of the effect. The adequate pharmacological manipulation of such mechanisms may improve EA effectiveness for pain management.

Topics: Adjuvants, Anesthesia; Adrenergic alpha-Antagonists; Analgesia; Anesthetics, Intravenous; Animals; Atropine; Baclofen; Bicuculline; Biophysics; Dioxanes; Disease Models, Animal; Electroacupuncture; GABA Agents; Male; Methysergide; Models, Biological; Multivariate Analysis; Naloxone; Narcotic Antagonists; Pain; Pain Management; Pain Measurement; Rats; Rats, Wistar; Reaction Time; Serotonin Antagonists; Tail; Thiopental; Time Factors

The extract of the nut of Tetracarpidium conophorum (TC), commonly known as African walnut, is widely used to relieve pain, increase sperm count, enhance sexual performance in males and as a nerve tonic in ethnomedicine. This study describes the psychopharmacological properties of the aqueous extract of the nut of TC in mice. The spectrum of activities studied were the effects of TC on the duration of immobility in the forced swim test of the behavioural despair model of depression; prolongation of the duration of sleep produced by thiopentone; amphetamine-induced stereotyped behaviour; and on pain episodes produced by acetic acid and by formalin. Orally administered TC (50-200 mg/kg) produced a significant and dose-related decrease in the duration of immobility in the forced swim test in mice. TC also exhibited analgesic property, as shown by its ability to reduce the frequency of abdominal constrictions induced by acetic acid and to inhibit the nociceptive responses produced by formalin. However, at the tested oral doses of 50-200 mg/kg, TC did not prolong the duration of sleep produced by thiopentone nor alter the pattern of the stereotyped behaviour induced by amphetamine. This investigation provides evidence that may support the ethnomedicinal applications of the extract of the nut of TC in the treatment of pain. The study also revealed that TC seems to demonstrate antidepressant-like activity, as evidenced by its ability to shorten the period of immobility in the forced swim test; however, further studies are necessary to clearly define the role of TC in depression.

Topics: Acetic Acid; Alkaloids; Amphetamine; Animals; Antidepressive Agents; Euphorbiaceae; Female; Formaldehyde; Male; Mice; Motor Activity; Pain; Plant Extracts; Saponins; Thiopental

The percentile-finding experimental design known variously as 'forced-choice fixed-staircase', 'geometric up-and-down' or 'k-in-a-row' (KR) was introduced by Wetherill four decades ago. To date, KR has been by far the most widely used up-and-down (U&D) design for estimating non-median percentiles; it is implemented most commonly in sensory studies. However, its statistical properties have not been fully documented, and the existence of a unique mode in its asymptotic treatment distribution has been recently disputed.Here we revisit the KR design and its basic properties. We find that KR does generate a unique stationary mode near its target percentile, and also displays better operational characteristics than two other U&D designs that have been studied more extensively. Supporting proofs and numerical calculations are presented. A recent experimental example from anesthesiology serves to highlight some of the 'up-and-down' design family's properties and advantages.

Topics: Anesthesiology; Anesthetics, Intravenous; Biometry; Clinical Trials, Phase I as Topic; Humans; Markov Chains; Models, Statistical; Pain; Propofol; Thiopental

Topics: Anesthetics, Intravenous; Humans; Injections, Intravenous; Pain; Propofol; Thiopental

The somatosensory-evoked potential (SEP) elicited by high-intensity stimulation potentially provides a reliable indicator of analgesic efficacy since it reflects the level of activation of the nociceptive system. In the present study, components in the 10-30-ms latency range of SEPs recorded over the primary somatosensory cortex (SI-SEPs) and vertex (Vx-SEP) in the rat were characterized and compared. SEPs were elicited by electrical tail-base stimulation, and SI-SEPs and Vx-SEPs were recorded simultaneously. Responses to increasing stimulus intensity and stimulus frequency while awake and responses to bolus injection of fentanyl, thiopental, and ketamine were investigated. The SI-SEP positive component (P) occurring at 12 ms after stimulation (P12) showed a significantly lower intensity threshold and was significantly less affected by increasing stimulus frequency and by administration of the different drugs when compared to the Vx-SEP P15. The fact that a single stimulus modality results in different signal characteristics dependent on the recording site supports the view that different neural mechanisms involved in primary processing of somatosensory information are responsible for the generation of the SI-SEP P12 and Vx-SEP P15, respectively. This differentiation between SI-SEPs and Vx-SEPs potentially has distinct consequences using the SEP to evaluate nociception and analgesia in the rat model.

Topics: Anesthetics; Animals; Brain Mapping; Cerebral Cortex; Electric Stimulation; Evoked Potentials, Somatosensory; Fentanyl; Ketamine; Male; Mental Processes; Pain; Pain Measurement; Rats; Rats, Wistar; Reaction Time; Somatosensory Cortex; Tail; Thiopental

Topics: Asphyxia; Capital Punishment; Consciousness; Drug-Related Side Effects and Adverse Reactions; Humans; Injections, Intravenous; Kentucky; Pain; Pancuronium; Pharmaceutical Preparations; Potassium Chloride; Prisoners; Thiopental

Thiopental has hypnotic actions in the brain, but it also depresses nociceptive transmission. In this study we examined whether thiopental had direct (spinal) and/or indirect (supraspinal) effects on the responses of single lumbar dorsal horn neurons to noxious mechanical stimulation, using a method to deliver thiopental differentially to either the torso or cranial circulation in goats.. Goats (n=10) were anesthetized with isoflurane and neck dissections performed to permit cranial bypass. A lumbar laminectomy was made to permit single-unit recording of lumbar dorsal horn neuronal activity (1-2 neurons/animal). Isoflurane was maintained at 0.8+/-0.1% to both head and torso throughout the study. During cranial bypass, thiopental was separately administered to the torso (low dose, 1.5+/-0.5 mg/kg; high dose, 3.7+/-0.5 mg/kg) or cranial (low dose, 0.12+/-0.03 mg/kg; high dose, 0.2 mg/kg) circulation.. Thiopental administered to the torso significantly depressed dorsal horn neuronal responses to noxious stimulation at the high dose: 757+/-471 to 392+/-305 impulses/min at 1 min post-injection, P<0.006 (n=14); evoked responses recovered at 5 min post-injection. At the low dose, there was a similar numerical decrease, but this did not reach significance: 876+/-780 to 407+/-499 impulses/min at 1 min post-injection, P>0.05 (n=6). No significant change was observed when thiopental was administered to the cranial circulation: low dose, 1061+/-1167 to 965+/-874 impulses/min at 1 min post-injection, P>0.05 (n=10); high dose, 864+/-331 to 917+/-525 impulses/min at 1 min post-injection, P>0.05 (n=8).. Thiopental has a direct (spinal) depressant effect on dorsal neuronal responses to noxious stimulus, but no significant supraspinal effect.

Topics: Anesthetics, Intravenous; Animals; Blood Gas Analysis; Blood Glucose; Coronary Circulation; Depression, Chemical; Goats; Hematocrit; Pain; Pain Measurement; Physical Stimulation; Posterior Horn Cells; Synaptic Transmission; Thiopental

A patient who was unresponsive to multiple conservative medical treatments for complex regional pain syndrome was assessed using a novel approach--the sodium pentothal hypnosis interview. The interview suggested that his pain was centrally generated. The patient's pain symptoms resolved with hypnotherapeutic treatment. Indications for this procedure and implications for assessment and treatment are discussed. This case raises more questions than it answers, and leaves the reader to struggle with current difficulties in diagnostic decision-making.

Topics: Adult; Humans; Hypnotics and Sedatives; Interview, Psychological; Male; Narcotherapy; Pain; Pain Management; Syndrome; Thiopental

The physical compatibility of thiopentone and propofol mixtures was investigated. The investigations used were macroscopic and microscopic observations, zeta potential and oil droplet size measurements. There was no evidence of instability in the mixtures. The thiopentone-propofol mixture has the potential advantage of reducing the pain on injection, provides synergistic interaction, does not prolong recovery when used for induction of anaesthesia, may reduce the incidence of convulsions and is cost-effective.

Topics: Anesthesia Recovery Period; Anesthetics, Intravenous; Chemical Phenomena; Chemistry, Physical; Cost-Benefit Analysis; Drug Stability; Drug Synergism; Electric Conductivity; Electrochemistry; Emulsions; Humans; Incidence; Injections, Intravenous; Pain; Propofol; Seizures; Thiopental

One hundred and twenty-seven children aged 3-6 years were allocated to four groups. All of them received venous cannulation on the dorsum of the hand. On induction, the group L1, L2 and L3 patients received propofol 3 mg/kg mixed with lignocaine 0.15 mg/kg, 0.3 mg/kg, 0.6 mg/kg, respectively. The group T patients received thiopentone 3 mg/kg, then propofol 1.5 mg/kg mixed with lignocaine 0.075 mg/kg. Pain on injection was categorized into two-assessment items (facial expression and limbs withdrawal). The facial expression category were subdivided into none, mild (knit of brows), moderate (grimace), and severe (crying). The withdrawal of limbs was categorized into none, mild (withdrawal of hand), moderate (withdrawal of fore-arm and arm), severe (withdrawal of arm and twisting of body). Patients were monitored using an electrocardiogram, pulse oximeter, autonomic noninvasive blood pressure measuring device and capnography. The patient characteristics did not differ significantly among the four groups. Pain on injection was significantly more frequent in the group L1 patients (81%) compared with the group T (27%) patients. Increasing lignocaine dose reduced the incidence of pain graded as "moderate" or "severe" though there was no significant difference. The incidences of excitatory effect on propofol injection were reduced with increasing lignocaine dose and prior administration of thiopentone but there were no obviously differences among groups. We concluded that thiopentone reduced injection pain on propofol and should be recommended.

Topics: Anesthetics, Intravenous; Child; Child, Preschool; Female; Humans; Injections, Intravenous; Male; Pain; Propofol; Thiopental

Hysterical illness may be defined as symptoms normally associated with disease without pathological basis. Orthopaedics attracts more of these patients than most specialties. They are intensively and expensively investigated, yet clinicians remain anxious they are missing genuine pathology. We use examination under pentothal, without analgesia, to help distinguish real from imagined symptoms. The results of a review of patients evaluated under pentothal over the past two years are presented.

Topics: Adolescent; Adult; Child; Diagnosis, Differential; Female; Humans; Hypnotics and Sedatives; Hysteria; Male; Middle Aged; Musculoskeletal Diseases; Pain; Retrospective Studies; Thiopental

This study was conducted to determine whether hyperalgesic effects of subanaesthetic concentrations of thiopentone could be attributed to GABAA receptor effects.. All studies were performed on 50 rats in a prospective, randomized, blinded fashion using saline-injected animals as controls. Using a modified Randall-Selitto technique, the motor behavior stimulated by noxious stimulation was quantified by determining the lowest tail pressure required to provoke a withdrawal response (somatic motor response threshold, SMRT). In the first protocol (21 rats), we studied the effects of 0.5, 1.5 and 5 mg.kg-1 i.v. of the GABAA agonist, muscimol, on SMRT. In the second protocol (20 rats), the effects of administration of saline, muscimol 0.5 mg.kg-1, or the competitive GABAA antagonist, bicuculline 0.25 mg.kg-1, upon the SMRT-reducing effects of a standardized thiopentone infusion were observed.. No dose of muscimol produced hyperalgesia. The highest dose of muscimol used (5 mg.kg-1) produced pronounced analgesic effects, raising the SMRT above 750 g. No change in SMRT was detected with the smaller doses of muscimol. Given in combination with muscimol (0.5 mg.kg-1), thiopentone produced analgesia, as shown by an increase in SMRT (P = 0.009). In the bicuculline treated animals, SMRT decreased linearly with increasing plasma thiopentone concentrations (P < 0.001). The slope of the relationship in the bicuculine group was not significantly different from that observed in the saline-treated group, indicating that bicuculline did not block the hyperalgesic effects of thiopentone.. The results of these studies suggest that hyperalgesia associated with thiopentone is not mediated primarily by GABAA receptors.

Topics: Animals; Bicuculline; GABA Modulators; Hypnotics and Sedatives; Male; Muscimol; Pain; Rats; Rats, Sprague-Dawley; Receptors, GABA-A; Thiopental

Topics: Humans; Injections, Intravenous; Lidocaine; Pain; Propofol; Thiopental

Topics: Humans; Injections, Intravenous; Pain; Propofol; Thiopental

Reversible thiopental blockade of sites located in the basal midbrain of conscious toads bearing chronically implanted cannulae induced a response in which the animal withdrew to the bottom of the experimental box with flexed head and forelegs. Partial or total eyelid closure, myosis, and reduced ventilatory movements also occurred. No significant changes in arterial pressure levels or heart rate occurred and the reflex wiping response to the application of a painful stimulus (acid) to the skin was also unaffected. However, the somatic and visceral responses to nonpainful stimuli were reduced. There was a decrease, but not abolition, of forebrain waves in the 11 Hz range grouped in spindles, perhaps due to the reduced ventilatory drive. On the basis of these findings and of previous data from our laboratory and others on other nonmammalian groups, we postulate the existence of neurons involved in the modulation of behavioral and visceral alerting in the basal midbrain.

Topics: Animals; Attention; Autonomic Nervous System; Bufonidae; Electric Stimulation; Electroencephalography; Escape Reaction; Female; Hemodynamics; Male; Mesencephalon; Microinjections; Pain; Respiration; Stereotaxic Techniques; Thiopental

To assess the adequacy of the general anesthesia commonly employed for Cesarean section, we used isolated forearm technique to study 30 parturients (physical status ASA I/II, aged 17-35 yr) scheduled for nonemergent abdominal delivery. Anesthesia was induced with intravenous thiopental (3 mg/kg, 250 mg maximum) and succinylcholine (1.5 mg/kg), and then proceeded with a mixture of 50% N2O, 50% O2, and 0.5% halothane at a flow of 5 L/min and end-tidal CO2 at 40 mm Hg. Paralysis was maintained with a 0.1% succinylcholine infusion. When eyelash reflex disappeared, patients received taped instruction via headphones at 1-min intervals for 10 min. The tapes instructed patients to flex fingers if they were able to hear, to make a fist or squeeze the investigator's hand if they felt pain, to remember six target words, and to respond with specific physical signals during later interviews. Three sets of tapes assigned at random were used in the study. For signs of inadequate anesthesia, other variables such as eye centering, pupil size, sweating, and lacrimation were concomitantly monitored at the time of induction, laryngoscopy/intubation, and skin incision, and then at 1-min intervals for 10 min. Brain activity was also monitored by means of computerized aperiodic analysis of electroencephalogram Lifescan). Patients were interviewed in the postanesthesia recovery room and again 24 h later. At the time of skin incision, 96.7% of patients (29/30) signaled awareness by flexing fingers, 86.7% (26/30) exhibited lacrimation, and 80% (24/30) made a fist or squeezed the investigator's hand, indicating pain perception.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Anesthesia, General; Anesthesia, Obstetrical; Awareness; Cesarean Section; Female; Halothane; Humans; Nitrous Oxide; Pain; Pregnancy; Thiopental

The incidence and severity of muscle pains and changes in creatine kinase were assessed following administration of 1 mg.kg-1 suxamethonium either immediately or 2 min after induction of anaesthesia with propofol or thiopentone in patients undergoing elective dental and ophthalmic surgery. The incidence of muscle pains was 35 and 60% respectively in the groups given suxamethonium immediately and 2 min after propofol, and 35 and 55% when given immediately and 2 min after thiopentone, with no statistically significant differences among the groups. Creatine kinase levels increased in all the groups after operation with the least average increase in the group receiving suxamethonium immediately after propofol and the highest increase in the group receiving suxamethonium 2 min after thiopentone. There was no correlation between the incidence and severity of fasciculations, muscle pains and changes in creatine kinase within or between the groups. It is concluded that neither the induction agent nor the time between the induction agent and suxamethonium administration has any significant influence on the incidence of muscle pains or creatine kinase elevation following suxamethonium.

Topics: Adolescent; Adult; Aged; Anesthesia, Intravenous; Creatine Kinase; Fasciculation; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Postoperative Complications; Propofol; Succinylcholine; Thiopental

Barbiturates are often described as non-analgesic or even hyperalgesic agents; the newer intravenous anesthetic agent propofol is said to be non-analgesic. Both propofol and barbiturates occupy sites on the GABAA receptor. The present study was designed to compare the effects of propofol and barbiturates on nociceptive-related neurotransmission in neonatal rat spinal cord; to search for actions that might be hyperalgesic; and to determine the extent to which propofol depression of nociceptive neurotransmission is mediated by GABAA receptors. The monosynaptic reflex, a slow ventral root potential (slow VRP) and the dorsal root potential (DRP) were recorded from isolated neonatal (1-5 days old) superfused rat spinal cords in response to electrical stimulation of a lumbar dorsal root. The slow VRP and the DRP are related to nociception. Propofol (0.5-10 microM), pentobarbital (1-10 microM), and thiopental (1-10 microM) reversibly depressed the slow VRP. Dose-response curves were monophasic and linear over this range. The monosynaptic reflex was unaffected. The GABAA agonist muscimol (0.2-1 microM) also depressed the slow VRP. Propofol and barbiturate slow VRP depression was antagonized by the GABAA antagonist bicuculline (1 microM). Propofol depressed the response evoked by direct application of substance P. The DRP is a GABAA-mediated depolarization of primary afferent nerve terminals that diminishes the effectiveness of nociceptive input. Propofol and thiopental increased electrically evoked DRP amplitude and increased the DRP evoked by application of muscimol. Both propofol and barbiturates thus depressed the nociceptive-related slow VRP and enhanced the antinociceptive DRP; their effective concentrations are at or close to the general anesthetic range for these agents. No anti-analgesic or hyperalgesic effect was observed. (ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Animals, Newborn; Depression, Chemical; Hyperalgesia; In Vitro Techniques; Pain; Pentobarbital; Propofol; Rats; Rats, Sprague-Dawley; Receptors, GABA-A; Spinal Cord; Spinal Nerve Roots; Synaptic Transmission; Thiopental

Topics: Humans; Pain; Propofol; Thiopental

The effects of levocabastine (R 50 547; CAS 79516-68-0) on the central nervous system were studied in comparison with those of diphenhydramine, ketotifen and azelastine. At high doses, levocabastine caused a decrease in locomotor activity, prolongation of thiopental-induced sleep, depression of acetic acid-induced writhing in mice and inhibition of active avoidance response in rats, but these adverse effects were much less potent than those seen in diphenhydramine, ketotifen and azelastine. Oxotremorine-induced tremor and salivation in mice were delayed after extremely high dosage of levocabastine; however, these were much less effective than those seen after diphenhydramine and ketotifen. Levocabastine did not affect the tonic extensor seizure induced by maximal electroshock in mice which is different from that of diphenhydramine. In EEG analysis, levocabastine at a dose of 20 mg/kg caused no significant changes in the EEG recorded from the frontal cortex, occipital cortex, hippocampus and amygdala in rats with chronic electrodes.

Topics: Acetates; Animals; Avoidance Learning; Central Nervous System; Electroencephalography; Histamine H1 Antagonists; Male; Mice; Mice, Inbred Strains; Motor Activity; Oxotremorine; Pain; Piperidines; Rats; Rats, Inbred Strains; Salivation; Sleep; Thiopental; Tremor

Topics: Adolescent; Adult; Aged; Anesthesia, Intravenous; Female; Humans; Middle Aged; Pain; Propofol; Thiopental

Work and injury related musculoskeletal pain is often complicated by psychological and medicolegal factors that obscure the validity of the pain presentation. Pressure algometry and stretching during thiopentone sodium (Pentothal) anesthesia was studied in 45 cases of musculoskeletal injury. A total of 40 cases were determined as genuine, organic pain, four cases were negative (i.e., nonorganic pain), and one case was equivocal. In unilateral pain cases, a right to left pressure threshold difference of 2.0 kg/cm2 predicted 94% of true organic pain cases and 100% of cases at a pressure threshold of 1.5 kg/cm2 if combined with stretching. Results of stretching painful areas correlated highly with pressure threshold assessments.

Topics: Achilles Tendon; Adult; Anesthesia; Female; Humans; Male; Malingering; Middle Aged; Musculoskeletal System; Pain; Pain Measurement; Sensory Thresholds; Thiopental

Eleven patients who had been fully investigated and diagnosed by orthopaedic surgeons as suffering from non-organic locomotor disorders were assessed and treated by a psychiatrist (AW) using a technique involving one or more injections of thiopentone sodium. The patients had been ill for an average of 3.4 yr (3 mths to 10 yr) and suffered severe disablement. Injections of short-acting barbiturates have been used for many years to facilitate the release and discussion of repressed feelings and emotions (narcoanalysis). This paper describes the use of a similar injection but given to facilitate the movement and return to normality of muscles whose function is deranged. The authors suggest that this technique be called 'narcokinesis'. All eleven patients showed initial improvement with seven patients showing moderate or marked benefit from the treatment at the time of discharge from hospital. A detailed case study is described of the advantages of narcokinesis and possible mode of action discussed. The general practitioners of these patients were sent a questionnaire by post and all replied. At the time of follow-up (6-9 yr) the whereabouts of three patients were unknown, three had died, two remained ill and three patients remained well or moderately well.

Topics: Adolescent; Adult; Child; Conversion Disorder; Female; Follow-Up Studies; Humans; Locomotion; Male; Middle Aged; Pain; Thiopental

The effect of pentobarbitone and thiopentone on stress-induced analgesia was studied in 40 male Sprague-Dawley rats. Antinociception was determined by measuring motor reaction threshold to the noxious pressure on the tail with the use of an "Analgesymeter." Stress was induced by placement of a clamp on the hind paw. The stress procedure was found to cause an increase in reaction threshold, which was partially suppressed by naloxone 0.5 mg X kg-1. Pentobarbitone in a subanaesthetic dose of 25 mg X kg-1, SC, almost completely abolished the stress-induced increase in the reaction threshold (an increase in reaction threshold from 329 +/- 33 g to 486 +/- 62 g in control group, and from 250 +/- 26 g to 273 +/- 35 g in pentobarbitone group, p less than 0.02 for the difference in the threshold changes). Thiopentone used in a dose of 25 mg X kg-1, IV, caused a loss of the righting reflex for 37 +/- 10 minutes; stress procedure applied ten minutes after regaining the righting reflex did not cause any increase in the reaction threshold (with an increase in the reaction threshold in control group from 355 +/- 50 g to 540 +/- 26 g, p less than 0.001 for the difference between the groups). The results suggest that the barbiturates in subanaesthetic doses inhibit stress-induced analgesia. Thiopentone used in an anaesthetic dose has the potential for inhibition of stress-induced analgesia in the period of recovery from anaesthesia.

Topics: Animals; Male; Naloxone; Pain; Pain Measurement; Pentobarbital; Rats; Rats, Inbred Strains; Sensory Thresholds; Stress, Physiological; Thiopental

The induction characteristics of thiopentone, etomidate and methohexitone have been compared to those of propofol (2,6 di-isopropyl phenol) in unpremedicated patients. Propofol 2.5 mg/kg caused significantly more hypotension, excitatory side effects and pain on injection at the dorsum of hand than thiopentone 5 mg/kg. However, with regard to the latter two sequelae, etomidate 0.3 mg/kg and methohexitone 1.5 mg/kg caused similar or more frequent upset. Propofol 2.0 mg/kg was equipotent with thiopentone 4.0 mg/kg in terms of successful induction of anaesthesia. Hypotension may contraindicate the use of propofol in the hypovolaemic or unfit patient.

Topics: Adult; Anesthesia, Intravenous; Anesthetics; Drug Evaluation; Etomidate; Female; Hemodynamics; Humans; Male; Methohexital; Pain; Phenols; Propofol; Respiration; Thiopental

The effects of morphine-thiopental and fentanyl-thiopental combinations on the movement response caused by tail clamping were studied in rats. Doses that prevented movement response when the agents were given singly and when the agents were given in combination were determined by a probit procedure and compared with isobolographic analysis. With doses of the above agents sufficient to block the movement response to tail clamping (ED50 values: 4.7 (3.3-6.6) mg/kg intravenously for morphine; 8.3 (5.8-11.3) micrograms/kg intravenously for fentanyl; and 18.8 (17.9-19.7) mg/kg intravenously for thiopental) both fentanyl and, to a lesser extent, morphine have a less than additive or an antagonistic interaction with thiopental. This antagonism is a relative one that does not increase the requirement for one agent upon the addition of another agent.

Topics: Animals; Dose-Response Relationship, Drug; Drug Interactions; Fentanyl; Male; Morphine; Movement; Pain; Rats; Rats, Inbred Strains; Respiration; Thiopental

The effects of sodium thiopental on the single-unit activity of cells in the nucleus reticularis gigantocellularis (NRGG) were examined in decerebrated cats. Only cells in the NRGC that responded exclusively to electrical stimulation of A-delta fibers (noxious stimulation) in the superficial radial nerve were studied. Sodium thiopental caused a significant, dose-dependent suppression of spontaneous and evoked neuronal activity of cells in the NRGC. Spontaneous activity was suppressed by 66% and 98% after intravenous administration of sodium thiopental, 2.5 mg/kg and 5.0 mg/kg, respectively. Evoked activity was suppressed by 65% and 79%. These findings, when added to previous reports of the suppressive effects of nitrous oxide, morphine sulfate, ketamine hydrochloride, and halothane, suggest the involvement of the NRGC in nociception and provide evidence that sodium thiopental significantly modifies the neuronal message about a noxious stimulus as recorded at the level of the NRGC.

Topics: Action Potentials; Animals; Cats; Evoked Potentials; Female; Male; Medulla Oblongata; Neural Pathways; Neurons; Pain; Radial Nerve; 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: Adolescent; Adult; Anesthesia; Diazepam; Dose-Response Relationship, Drug; Etomidate; Humans; Imidazoles; Ketamine; Middle Aged; Pain; Propanidid; Thiopental

Topics: Ambulatory Care; Bronchoscopy; Humans; Male; Muscles; Pain; Pharyngitis; Propanidid; Succinylcholine; Thiopental

Topics: Animals; Asphyxia; Blood Pressure; Body Temperature; Cats; Cervical Plexus; Evoked Potentials; Light; Neurons; Neurons, Efferent; Pain; Pentobarbital; Respiration; Sympathetic Nervous System; Thiopental; Tubocurarine; Visual Perception

Topics: Alcohol Withdrawal Delirium; Chlormethiazole; Chlorpromazine; Chlorprothixene; Diazepam; Family Characteristics; Haloperidol; Hospitalization; Humans; Immobilization; Medication Errors; Neurocognitive Disorders; Pain; Paraldehyde; Phenobarbital; Physician-Patient Relations; Psychomotor Disorders; Psychoses, Substance-Induced; Psychotic Disorders; Thiopental

Topics: Amnesia; Anesthesia, Intravenous; Anesthesia, Obstetrical; Apgar Score; Atropine; Cesarean Section; Consumer Behavior; Creatine Kinase; Diazepam; Female; Humans; Infant, Newborn; Nitrous Oxide; Pain; Preanesthetic Medication; Pregnancy; Stimulation, Chemical; Succinylcholine; Thiopental

Topics: Anaphylaxis; Anesthesia, General; Constriction; Coronary Vessels; Female; Humans; Middle Aged; Muscles; Pain; Propanidid; Thiopental; Thorax

Topics: Acidosis, Respiratory; Analgesia; Anesthesia, Conduction; Anesthesia, Epidural; Anesthesia, Obstetrical; Bradycardia; Delivery, Obstetric; Drug Therapy, Combination; Extraction, Obstetrical; Female; Humans; Infant, Newborn; Injections, Intravenous; Labor, Obstetric; Meperidine; Naloxone; Pain; Pregnancy; Respiratory Distress Syndrome, Newborn; Respiratory Insufficiency; Thiopental; Tranquilizing Agents; Vasoconstrictor Agents

Topics: Adolescent; Adult; Aged; Anesthesia, General; Anesthesia, Inhalation; Attitude; Cognition; Diazepam; Female; Fentanyl; Halothane; Humans; Male; Meperidine; Middle Aged; Nitrous Oxide; Oxygen; Pain; Patients; Pentobarbital; Preanesthetic Medication; Promethazine; Thiopental; Time Factors

Topics: Anesthesia, General; Anesthetics; Female; Humans; Ketones; Pain; Pregnanes; Thiopental

Topics: Analgesia; Analgesics; Anesthesia, General; Atropine; Cyclohexanes; Female; Humans; Ketamine; Opium; Pain; Preanesthetic Medication; Thiopental

Topics: Adult; Analgesics; Cyclohexanes; Ear, External; Female; Humans; Male; Pain; Propanidid; Thiopental

Topics: Adult; Electric Stimulation; Female; Galvanic Skin Response; Histamine; Humans; Pain; Pain Insensitivity, Congenital; Perception; Personality Disorders; Psychology, Social; Skin; Sleep; Thiopental

Topics: Adult; Barbiturates; Bronchoscopy; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Muscle Proteins; Muscles; Muscular Diseases; Neostigmine; Pain; Postoperative Complications; Potassium; Succinylcholine; Thiopental; Tubocurarine

Topics: Analgesia; Anesthesia; Anesthetics; Humans; Nociceptive Pain; Pain; Pharmacology; Propanidid; Thiopental

Topics: Administration, Intravenous; Anesthesia; Anesthesia, Intravenous; Anesthesiology; Atropine; Bronchoscopy; Drug Therapy; Humans; Muscle Relaxants, Central; Neostigmine; Neuromuscular Depolarizing Agents; Pain; Preanesthetic Medication; Thiopental

Topics: Adolescent; Analgesia; Biomedical Research; Child; Geriatrics; Humans; Nitrous Oxide; Pain; Pain Management; Pharmacology; Statistics as Topic; Succinylcholine; Surgical Procedures, Operative; Thiopental

Topics: Analgesia; Animals; Codeine; Meperidine; Mice; Morphine; Pain; Pain Management; Pharmacology; Research; Thiopental

Topics: Analgesics; Analgesics, Non-Narcotic; Anesthesia; Anesthesiology; Antipyretics; Drug Therapy; Humans; Methohexital; Nociceptive Pain; Pain; Postoperative Complications; Thiopental

Topics: Amphetamine; Amphetamines; Animals; Aspirin; Body Temperature Regulation; Chlordiazepoxide; Chlorpromazine; Electrophysiology; Ether; Guinea Pigs; Hexobarbital; Meprobamate; Mice; Morphine; Nikethamide; Pain; Pentylenetetrazole; Pharmacology; Phenobarbital; Poisoning; Psychopharmacology; Rabbits; Research; Sensory Receptor Cells; Sleep; Strychnine; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, General; Humans; Oxytocics; Pain; Pain Management; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Barbiturates; Ozone; Pain; Pain Management; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Electroconvulsive Therapy; Humans; Pain; Succinylcholine; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Pain; Pain Management; Pain Threshold; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Animals; Horses; Pain; Pain Management; Thiopental

For 24 hr. after intravenous administration of buthalitone or thiopentone, plasma concentrations in young human subjects have been followed. Buthalitone was distributed to the tissues more rapidly but was metabolized at a slower rate than thiopentone. The relationships between these findings and differences in plasma protein binding and oil/water partition coefficients were studied. It is suggested that some of the differences observed in potency between the substances is a reflection of differences in their modes of distribution. No relationship was found between speed of recovery from anaesthesia and plasma barbiturate concentrations.

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Barbiturates; Blood Proteins; Humans; Pain; Pain Management; Protein Binding; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Emotions; Humans; Pain; Pain Management; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, Dental; Hand; Pain; Pain Management; Persons with Mental Disabilities; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Pain; Respiration; Thiopental

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, Inhalation; Anesthesiology; Levallorphan; Meperidine; Morphine; Nitrous Oxide; Oxygen; Pain; Thiopental

Topics: Adenoids; Analgesia; Anesthesia; Anesthesia and Analgesia; Anesthesia, General; Pain; Pain Management; Palatine Tonsil; Procaine; Thiopental; Tonsillectomy

Topics: Analgesia; Anesthesia; Anesthesia and Analgesia; Pain; Pain Management; Procaine; Stomach; Thiopental