thiopental and Tachycardia

To compare intubation conditions and hemodynamic effects resulting from thiopental-rapacuronium, propofol-rapacuronium, and etomidate-rapacuronium intravenous (IV) induction.. Randomized, blinded study.. Operating suites of a large university-affiliated medical center.. 60 ASA physical status I and II adult patients without airway abnormalities, who were scheduled for elective surgery requiring endotracheal intubation. Patients were randomly allocated to receive IV thiopental sodium 5 mg/kg (Group 1), propofol 2 mg/kg (Group 2), or etomidate 0.3 mg/kg (Group 3) followed by rapacuronium 1.5 mg/kg. Fifty seconds later, an anesthesiologist, who had no knowledge of the induction drug used, entered the operating room and attempted laryngoscopy and intubation.. Intubation conditions were graded as excellent, good, poor, or impossible according to Good Clinical Research Practice criteria. Arterial blood pressure and heart rate changes accompanying both induction techniques were also monitored and recorded.. All patients were intubated within 55 to 70 seconds. Clinically acceptable intubation conditions were not statistically different among the three groups. Moderate tachycardia after induction was seen in all three groups, and blood pressure was significantly lower in Group 2 than in Groups 1 or 3.. Clinically acceptable intubation conditions are similar after either thiopental, propofol, or etomidate when a fast-onset neuromuscular blocking drug (rapacuronium 1.5 mg/kg) is used to facilitate tracheal intubation.

Topics: Adult; Anesthesia, General; Anesthesia, Intravenous; Anesthetics, Intravenous; Blood Pressure; Double-Blind Method; Etomidate; Female; Heart Rate; Humans; Intubation, Intratracheal; Laryngoscopy; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Propofol; Tachycardia; Thiopental; Vecuronium Bromide

Posterior reversible encephalopathy syndrome refers to a neuroradiologic disorder in which seizure activity (multiple seizures are more common than single events) is commonly the initial presenting symptom. We describe a case of posterior reversible encephalopathy syndrome in a previously healthy parturient who presented to the labor and delivery suite with generalized tonic-clonic seizures. Prompt recognition and treatment of this potentially catastrophic disease may avert injury to the patient and neonate.

Topics: Adolescent; Anesthetics, Intravenous; Anticonvulsants; Brain; Cesarean Section; Epilepsy, Tonic-Clonic; Factor V; Female; Humans; Hypertension; Intubation, Intratracheal; Magnesium Sulfate; Magnetic Resonance Imaging; Neuromuscular Depolarizing Agents; Pregnancy; Pregnancy Complications; Pregnancy Trimester, Third; Succinylcholine; Syndrome; Tachycardia; Thiopental; Tomography, X-Ray Computed

Topics: Adolescent; Adult; Aged; Anesthetics, Intravenous; Hemodynamics; Humans; Hypertension; Intubation, Intratracheal; Middle Aged; Propofol; Prospective Studies; Random Allocation; Tachycardia; Thiopental

Previous reports have suggested that tachycardia alone can increase the rate of myocardial uptake of some drugs. As part of a systematic study of the determinants of the myocardial uptake and effects of drugs in critical illness, the effect of tachycardia induced by intracardiac pacing on the myocardial disposition and effects of lidocaine, verapamil, and thiopental were studied in chronically instrumented sheep. For each drug, seven sheep received either 100 mg of lidocaine, 10 mg of verapamil, or 750 mg of thiopental over 2 min in unpaced and paced (140 beats/min) states on separate occasions and in random order. Arterial and coronary sinus (effluent from the heart) blood samples were taken at regular intervals for 30 min, and the maximum rate of change of left ventricular pressure (LV dP/dtmax) was measured as an index of myocardial contractility. There were no differences between unpaced and paced studies in the time courses of arterial and coronary sinus concentrations, or the time-courses of myocardial contractility and blood flow, after bolus iv injections of these drugs. Tachycardia alone does not appear to influence the myocardial kinetics or dynamics of lipophilic drugs that can rapidly diffuse into the heart.

Topics: Animals; Anti-Arrhythmia Agents; Cardiac Pacing, Artificial; Coronary Vessels; Female; Heart Rate; Injections, Intravenous; Lidocaine; Myocardial Contraction; Myocardium; Sheep; Tachycardia; Thiopental; Verapamil

Topics: Aged; Anaphylaxis; Anesthesia, Intravenous; Anesthetics, Intravenous; Bronchial Spasm; Humans; Hypotension; Male; Neuromuscular Nondepolarizing Agents; Pancuronium; Propofol; Tachycardia; Thiopental

Topics: Anesthesia; Animals; Buffaloes; Chloral Hydrate; Hypotension; Hypoventilation; Male; Tachycardia; Thiopental

Topics: Humans; Male; Middle Aged; Tachycardia; Thiopental

All physicians performing surgery while the patient is under general anesthesia must be aware of the existence of idiopathic malignant hyperthermia. A young adult had a malignant hyperthermic reaction despite four prior uneventful administrations of general anesthetics. To my knowledge, this is the first report of a patient who survived following a hyperthermic reaction, having sustained considerable residual brain damage. There is a great need for continuous body-temperature monitoring during general anesthesia.

Topics: Adolescent; Anesthesia, Inhalation; Brain Damage, Chronic; Chlorides; Heart Arrest; Humans; Male; Malignant Hyperthermia; Methoxyflurane; Sodium; Strabismus; Succinylcholine; Tachycardia; Thiopental

Anaphylaxis to suxamethonium in patients who gave no history of allergy is presented in this report. The diagnosis of anaphylaxis was based on a rapid onset of tachycardia, arterial hypotension, erythematous patches and oedema, and a positive reaction to a sensitivity test.

Topics: Adolescent; Adult; Anaphylaxis; Blood Pressure; Chlorpheniramine; Dexamethasone; Female; Gluconates; Humans; Male; Methoxamine; Oxygen Inhalation Therapy; Promethazine; Skin Tests; Succinylcholine; Tachycardia; Thiopental

Topics: Adult; Anaphylaxis; Anesthesia, Intravenous; Cyanosis; Drug Hypersensitivity; Female; Humans; Tachycardia; Thiopental

Topics: Adult; Aged; Anesthesia, General; Arteries; Benperidol; Blood Pressure; Cardiac Output; Diazepam; Electrocardiography; Female; Heart Rate; Humans; Hypertension; Intubation, Intratracheal; Laryngoscopy; Male; Methohexital; Middle Aged; Neuroleptanalgesia; Phenoperidine; Propanidid; Tachycardia; Thiopental; Vascular Resistance

Topics: Adult; Aged; Anesthesia, General; Arrhythmias, Cardiac; Atropine; Benperidol; Female; Fentanyl; Halothane; Heart Rate; Humans; Injections, Intravenous; Male; Meperidine; Middle Aged; Neostigmine; Nitrous Oxide; Oxygen; Tachycardia; Thiopental; Tubocurarine

Topics: Adult; Aminophylline; Anesthesia, General; Bronchial Spasm; Cyanosis; Cystoscopy; Drug Hypersensitivity; Female; Humans; Hydrocortisone; Hypotension; Male; Middle Aged; Tachycardia; Thiopental

Topics: Adolescent; Adult; Age Factors; Aged; Anesthesia, General; Arrhythmias, Cardiac; Benperidol; Bradycardia; Coronary Disease; Cysts; Electrocardiography; Halothane; Humans; Jaw Fractures; Lidocaine; Male; Methohexital; Middle Aged; Propanidid; Propranolol; Surgery, Oral; Tachycardia; Thiopental; Tooth Extraction

Topics: Anesthesia; Anesthetics; Arrhythmias, Cardiac; Atrial Flutter; Atropine; Electric Countershock; Electric Stimulation Therapy; Electroconvulsive Therapy; Humans; Mental Disorders; Methohexital; Propanidid; Succinylcholine; Tachycardia; Thiopental; Ventricular Fibrillation

Topics: Anesthesia, General; Child; Chlorpromazine; Fractures, Bone; Humans; Hypertension; Male; Meperidine; Nitrous Oxide; Oxygen; Promethazine; Radius Fractures; Tachycardia; Thiopental; Ulna; Urination Disorders

Topics: Adult; Aminobenzoates; Atropine; Bis-Trimethylammonium Compounds; Blood Pressure; Electrocardiography; Heart Conduction System; Humans; Hypertension; Male; Medication Errors; Meperidine; Preanesthetic Medication; Procaine; Pupil; Reflex, Pupillary; Seizures; Succinylcholine; Tachycardia; Thiopental

Topics: Animals; Arrhythmias, Cardiac; Blood Pressure; Female; Heart; Heart Rate; Horses; Immobilization; Injections, Intravenous; Male; Oxygen; Propranolol; Respiration; Succinylcholine; Tachycardia; Thiopental

Topics: Adult; Blood Flow Velocity; Blood Pressure; Carbon Dioxide; Cardiovascular System; Curare; Cyclopropanes; Halothane; Heart Rate; Humans; Hypercapnia; Hyperventilation; Narcotics; Respiration; Respiratory Function Tests; Tachycardia; Thiopental; Vascular Resistance

Topics: Acidosis; Adenosine Triphosphate; Anesthesia, General; Animals; Cyanosis; Fever; Halothane; Hyperventilation; Muscles; Oxygen; Prognosis; Sodium; Swine; Tachycardia; Thiopental

Topics: Anesthesia, Obstetrical; Anesthetics; Cesarean Section; Female; Humans; Hypoxia; Infant, Newborn; Pregnancy; Respiratory Function Tests; Tachycardia; Thiopental

Topics: Anesthesia, General; Arrhythmias, Cardiac; Atropine; Cardiac Surgical Procedures; Humans; Hyperventilation; Methoxyflurane; Nitrous Oxide; Oxygen; Postoperative Complications; Preanesthetic Medication; Scopolamine; Tachycardia; Thiopental; Thoracic Arteries; Tubocurarine; Ventricular Fibrillation

Topics: Animals; Arrhythmias, Cardiac; Consciousness; Halothane; Heart; Heart Rate; Horses; Oxygen; Propranolol; Sensory Receptor Cells; Stimulation, Chemical; Succinylcholine; Sympathetic Nervous System; Tachycardia; Thiopental

Topics: Anesthetics; Arrhythmias, Cardiac; Electrocardiography; Female; Humans; Male; Tachycardia; Thiopental

Topics: Adult; Anesthesia, General; Arrhythmias, Cardiac; Bronchoscopy; Cardiac Complexes, Premature; Electrocardiography; Female; Humans; Intubation, Intratracheal; Male; Middle Aged; Oxygen; Preanesthetic Medication; Succinylcholine; Tachycardia; Thiopental

Topics: Adolescent; Adult; Aged; Anesthetics; Apnea; Blood Pressure; Child; Female; Halothane; Humans; Hyperventilation; Hypotension; Male; Middle Aged; Postoperative Complications; Pulse; Tachycardia; Thiopental

Topics: Animals; Arrhythmias, Cardiac; Blood Pressure; Bradycardia; Dogs; Electric Stimulation; Electrocardiography; Heart Rate; Isoproterenol; Pharmacology; Research; Tachycardia; Thiamylal; Thiopental; Vagus Nerve

Topics: Adolescent; Anesthesia; Anesthesia, Intravenous; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Child; Electrocardiography; Geriatrics; Humans; Intubation; Intubation, Intratracheal; Succinylcholine; Surgical Procedures, Operative; Tachycardia; Thiopental; Ventricular Fibrillation

Topics: Anesthesia; Anesthesiology; Atrial Fibrillation; Atrial Flutter; Electric Countershock; Humans; Tachycardia; Thiopental

Topics: Anesthesia; Anesthesia, Intravenous; Arrhythmias, Cardiac; Catecholamines; Electrocardiography; Norepinephrine; Pharmacology; Physiology; Tachycardia; Thiopental; Toxicology