thiopental and Vomiting

Topics: Anesthesia; Barbiturates; Blood Circulation; Gastroesophageal Reflux; Humans; Hypotension; Intubation, Intratracheal; Neuromuscular Depolarizing Agents; Neuromuscular Nondepolarizing Agents; Reflex, Abnormal; Succinylcholine; Thiopental; Time Factors; Vomiting

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

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

Oculocardiac reflex (OCR) and postoperative vomiting are major complications of paediatric strabismus surgery.. Children (3-16 yr) undergoing elective strabismus surgery as inpatients were randomly allocated to four anaesthetic techniques: (A) thiopentone induction and isoflurane maintenance; (B) as (A) plus ondansetron 5 mg x m(-2) i.v.; (C) propofol induction and maintenance; (D) as (C) plus lignocaine 2 mg x kg(-1) i.v. All children received prophylactic atropine 0.02 mg x kg(-1) and alfentanil. Nitrous oxide was omitted.. Data on 157 children were analysed. The cumulative incidence of vomiting within 6 and 24 h after surgery with thiopentone-isoflurane was 26% and 46%, respectively. Adding ondansetron decreased the incidence to 8% and 33%, respectively. This improvement was significant within 6 h only; the number-needed-to-treat was 5.5 (95% CI 2.9-46). Propofol was not different from thiopentone-isoflurane. The addition of lignocaine to propofol was of no benefit. The risk of an OCR was significantly increased with propofol (incidence 40%) compared with isoflurane (14%); the number-needed-to-harm was 3.9 (95% CI 2.6-8).. Thiopental-isoflurane-air/O2-alfentanil resulted in a moderate risk of vomiting. Adding ondansetron significantly decreased this risk, but 6 children have to be treated for one to benefit in the early postoperative period. Propofol and propofol-lignocaine showed no benefit on vomiting but significantly increased the risk of an OCR despite high-dose prophylactic atropine.

Topics: Adolescent; Alfentanil; Analgesics, Opioid; Anesthesia, General; Anesthetics, Inhalation; Anesthetics, Intravenous; Anesthetics, Local; Antiemetics; Atropine; Child; Child, Preschool; Confidence Intervals; Elective Surgical Procedures; Hospitalization; Humans; Incidence; Injections, Intravenous; Isoflurane; Lidocaine; Mydriatics; Ondansetron; Postoperative Complications; Propofol; Reflex, Oculocardiac; Risk Factors; Strabismus; Thiopental; Vomiting

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

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

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

To determine whether propofol anaesthesia reduces the incidence of nausea and vomiting after ear surgery, 40 children aged 4-16 years were randomly assigned to receive either propofol or inhalational anaesthesia. Children in the propofol group had anaesthesia induced with propofol and maintained with propofol-nitrous oxide and those in the inhalational group had anaesthesia induced with thiopentone and maintained with isoflurane-nitrous oxide. Nausea and vomiting were recorded for 24 h after surgery and metoclopramide was offered to children who vomited more than twice. We found that 11 children (55%) who had propofol and 14 children (70%) who had inhalational anaesthesia vomited one or more times after surgery (difference not significant). The incidence of vomiting was lower in the propofol group during the first 2 h after surgery (0% and 25% propofol and inhalational groups, respectively) (p < 0.05) but was similar at all other time intervals. Rescue anti-emetic was given to two (10%) and eight (40%) children in the propofol and inhalational groups, respectively (p < 0.05). We conclude that propofol anaesthesia alone is not an effective means of preventing vomiting after middle ear surgery in children.

Topics: Adolescent; Anesthesia, Inhalation; Anesthesia, Intravenous; Anesthetics, Intravenous; Child; Child, Preschool; Humans; Myringoplasty; Postoperative Complications; Postoperative Period; Propofol; Thiopental; Vomiting

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

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

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

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

Previous studies have indicated that propofol anaesthesia may reduce the incidence of postoperative nausea and vomiting after strabismus surgery in children. This study was designed to investigate the incidence of vomiting after strabismus surgery at two different levels of propofol anaesthesia compared to thiopental/isoflurane anaesthesia.. Ninety ASA class I or II children, aged 5-14 yrs were randomly assigned to one of three groups: Group T/I (n = 30) induction with 5 mg kg-1 of thiopental and maintenance with isoflurane, group P5 (n = 31) induction with propofol 2 mg kg-1, maintenance with propofol infusion 5 mg kg-1 h-1 or group P10 (n = 29) induction with propofol 2 mg kg-1, maintenance with propofol 10 mg kg-1 h-1. All received glycopyrrolate, vecuronium, fentanyl and controlled ventilation with O2/N2O 30/70. Ketorolac i.v. was given to prevent postoperative pain. If additional analgesia was needed, ibuprofen/acetaminophen or buprenorphine was given according to clinical need.. There were no differences between study groups with respect to age, weight, history of previous anaesthesia or emesis after previous anaesthesia, duration of anaesthesia, surgery or sleep after anaesthesia, or number of muscles operated. The incidence of vomiting was 37%, 29% and 28% in groups T/I, P5 and P10, respectively. There were no statistically significant differences between the three groups in the incidence of vomiting. The median age of patients who vomited was 7.5 (range 5.0-13.7) yrs while the median age of the patients who did not vomit was 9.1 (range 5.0-14.0) yrs (P < 0.01).. In the present study, propofol anaesthesia compared to thiopental/isoflurane anaesthesia did not reduce the incidence of vomiting following strabismus surgery in children.

Topics: Adolescent; Anesthetics, Combined; Anesthetics, Inhalation; Anesthetics, Intravenous; Child; Child, Preschool; Female; Humans; Isoflurane; Male; Postoperative Complications; Propofol; Strabismus; Thiopental; Vomiting

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

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

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

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

We studied supplementation of propofol or thiopentone anaesthesia with 0.5 or 1.0 mg alfentanil or 0.05 or 0.1 mg fentanyl for minor gynaecological outpatient procedures. Four hundred patients scheduled for elective termination of pregnancy were randomly allocated to one of eight groups. Induction agent doses, peroperative complications, complaints about pain and emesis during the postoperative period, and time to discharge were studied. Propofol compared to thiopentone was associated with a shorter time to discharge, 103 +/- 28 and 115 +/- 33 minutes respectively (P < 0.05) and anxiety during recovery was more frequent in the thiopentone group (P < 0.05). The need for postoperative reserve analgesics was less in the alfentanil group (P < 0.05). We found, however, no major differences between the supplementations tested regarding the total dose of induction agent, emesis or time to discharge. Supplementation with 1.0 mg of alfentanil to propofol was found to be the best combination tested for short outpatient procedures.

Topics: Abortion, Induced; Adult; Alfentanil; Ambulatory Surgical Procedures; Anesthesia Recovery Period; Anesthesia, Intravenous; Anesthesia, Obstetrical; Anxiety; Drug Combinations; Female; Fentanyl; Humans; Intraoperative Complications; Pain, Postoperative; Patient Discharge; Postoperative Complications; Pregnancy; Propofol; Thiopental; Vomiting

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

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

The purpose of this study was to evaluate the haemodynamic changes during induction, as well as the speed and quality of recovery when propofol (vs thiopentone and/or halothane) was used for induction and maintenance of anaesthesia in paediatric outpatients. One hundred unmedicated children, 3-12-yr-old, scheduled for ambulatory surgery were studied. The most common surgical procedures performed were eye muscle surgery (42%), plastic surgery (21%), dental restoration (15%), and urological procedures (15%). The children were randomized to an anaesthetic regimen for induction/maintenance as follows: propofol/propofol infusion; propofol/halothane; thiopentone/halothane; halothane for both induction and maintenance. Succinylcholine 1.5 mg.kg-1 was used to facilitate tracheal intubation and N2O/O2 were used as the carrier gases in each case. All maintenance drugs were titrated according to the clinical response of the patient to prevent movement and/or maintain BP +/- 20% of baseline. Two patients (4%) who received propofol expressed discomfort during injection. The mean propofol dose required to prevent movement was 267 +/- 83 micrograms.kg-1.min-1. The overall pattern of haemodynamic changes, as well as awakening (extubation) times were not different among the four groups. Children who received propofol recovered faster (22 vs 29-36 min) (P < 0.05), were discharged home sooner (101 vs 127-144 min) (P < 0.05), and had less postoperative vomiting (4 vs 24-48%) (P < 0.05) than all others.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Ambulatory Surgical Procedures; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia, Intravenous; Blood Pressure; Child; Child, Preschool; Follow-Up Studies; Halothane; Heart Rate; Hemodynamics; Humans; Patient Discharge; Propofol; Thiopental; Time Factors; Vomiting

Propofol anaesthesia may reduce postoperative emesis. The purpose of this study was to compare the incidence of emesis after propofol anaesthesia with and without nitrous oxide, compared with thiopentone and halothane anaesthesia, in hospital and up to 24 hr postoperatively, in outpatient paediatric patients after strabismus surgery. Seventy-five ASA class I or II, unpremedicated patients, aged 2-12 yr were randomly assigned to one of three groups: Thiopentone, 6.0 mg.kg-1 i.v. induction followed by halothane and N2O/O2 for maintenance (T/H); propofol for induction, followed by propofol and oxygen for maintenance (P/O2); and propofol for i.v. induction, followed by propofol infusion and N2O/O2 for maintenance (P/N2O). All received vecuronium, controlled ventilation, and acetaminophen pr. Morphine was given as needed for postoperative analgesia. There were no differences in age, weight, number of eye muscles operated upon, duration of anaesthesia or surgery. The P/N2O group (255 +/- 80 micrograms.kg-1 x min-1) received less propofol than the P/O2 group (344 +/- 60 micrograms.kg-1 x min-1) (P < or = 0.0001) and had shorter extubation (P < 0.001) and recovery (P < 0.01) times. Emesis in the hospital, in both the P/N2O (4.0%) and P/O2 group (4.0%) was less than in the T/H group (32%) (P < 0.01). Antiemetics were required in four patients in the T/H group (16.0%). Overall emesis after surgery was not different among the groups: T/H (48%), P/O2 (28%) and P/N2O (42%). The use of propofol anaesthesia with and without N2O decreased only early emesis. This supports the concept of a short-acting, specific antiemetic effect of propofol.

Topics: Ambulatory Surgical Procedures; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia, Intravenous; Child; Child, Preschool; Female; Halothane; Humans; Incidence; Length of Stay; Male; Mental Recall; Metoclopramide; Nitrous Oxide; Postoperative Complications; Propofol; Strabismus; Thiopental; Vomiting

Clinical observations during anaesthesia and intubation of emergency patients are presented showing a differentiated impact of etomidate (Hypnomidate) on upper airway reflexes: a blockade of pharyngeal reflexes with sustained but possibly delayed laryngeal reflexes and a certain protection against laryngospasm and vomiting. In addition etomidate enables, preferably in combination, difficult intubation with sustained spontaneous breathing due to its low respiratory depressant effect. These features were confirmed in a small foreshortened clinical study using thiopentone (Trapanal) or etomidate without muscle relaxants, whereby the difference in high risk patients became obvious. The impact of anaesthetics on airway reflexes is generally concealed by muscular relaxants, and observations on this matter are difficult to make subject to quantifiable parameters and controlled studies; accordingly such observations are scarcely found in newer anaesthetic literature. In the development of new techniques for intubation and anaesthesia without muscle relaxation, these methodical problems deserve attention.

Topics: Etomidate; Gagging; Humans; Laryngismus; Larynx; Reflex; Thiopental; Vomiting

Forty-four children, ASA physical status I or II, aged 1.5-14 years and admitted for strabismus surgery, were studied. The study compared the postoperative condition after two different anesthesia methods. All children were premedicated with midazolam rectally, received glycopyrrolate i.v. and were then randomised to one of two anesthetic methods: 1) induction with thiopental, maintenance with halothane or 2) induction with propofol supplemented with fentanyl, maintenance with propofol infusion. In both groups, tracheal intubation was performed after vecuronium i.v. and the children were ventilated manually. Peroperatively, patients receiving propofol/fentanyl had more episodes of bradycardia (P less than 0.001). Times to spontaneous breathing and extubation were shorter in the propofol/fentanyl group (P less than 0.05) and there was also a lesser degree of sedation during the first 2 h postoperatively (P less than 0.01). Fewer children in the propofol/fentanyl group vomited postoperatively (P less than 0.05). The apprehension score was higher in the propofol/fentanyl group compared to the thiopental/halothane group (P less than 0.05). We conclude that children undergoing strabismus surgery anesthetized with propofol/fentanyl had more episodes of peroperative bradycardia, a lower incidence of postoperative vomiting and a shorter recovery time, and were more apprehensive during the initial postoperative period than children anesthetized with thiopental/halothane.

Topics: Adolescent; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia, Intravenous; Child; Child, Preschool; Female; Fentanyl; Halothane; Humans; Infant; Male; Propofol; Strabismus; Thiopental; Vomiting

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

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

Topics: Anesthesia, General; Anesthesia, Inhalation; Anesthesia, Intravenous; Anesthetics; Child; Child, Preschool; Fentanyl; Halothane; Humans; Meperidine; Morphine; Postoperative Complications; Randomized Controlled Trials as Topic; Risk Factors; Sufentanil; Thiopental; Tonsillectomy; Vomiting

Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitated with suxamethonium. In each group half of the children received pethidine 0.7 mg/kg after intubation and the remainder received saline. Ketamine increased arterial pressure after induction. The cardiovascular responses to intubation were more obvious after thiopentone and Althesin than after ketamine. Operating conditions, cardiovascular changes during operation and the course of extubation were similar in all groups. The recovery after ketamine was longer than after thiopentone and Althesin. Thiopentone was associated with significantly less vomiting immediately after operation than was Althesin and ketamine. In the period immediately after operation Althesin was associated with a higher need for analgesics compared with thiopentone and ketamine. Pethidine prolonged the recovery after thiopentone, decreased the incidence of vomiting immediately after operation associated with Althesin and increased that associated with ketamine.

Topics: Alfaxalone Alfadolone Mixture; Anesthesia, General; Blood Pressure; Child; Child, Preschool; Female; Humans; Ketamine; Male; Otorhinolaryngologic Diseases; Pain, Postoperative; Postoperative Complications; Pregnanediones; Thiopental; Vomiting

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

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

Topics: Adult; Amides; Anesthesia, General; Anisoles; Antiemetics; Benzoates; Clinical Trials as Topic; Ethylamines; Female; Genital Diseases, Female; Halothane; Humans; Middle Aged; Nausea; Nitrous Oxide; Oxygen; Papaverine; Placebos; Preanesthetic Medication; Scopolamine; Thiopental; Vomiting

Topics: Adult; Anesthesia; Benperidol; Blood Pressure; Depression, Chemical; Electrocardiography; Female; Fentanyl; Heart Rate; Histamine Release; Humans; Hypotension; Male; Preanesthetic Medication; Propanidid; Stimulation, Chemical; Thiopental; Tremor; Vomiting

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

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

Topics: Adolescent; Adult; Anesthesia, Inhalation; Antiemetics; Atropine; Chlorpromazine; Female; Halothane; Humans; Middle Aged; Nitrous Oxide; Oxygen; Postoperative Complications; Preanesthetic Medication; Thiopental; Trichloroethylene; Vomiting

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

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

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

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

Strabismus surgery in children is associated with side-effects, intraoperative oculocardiac reflexes in relation with muscular tractions and postoperative vomiting. Studies with propofol anaesthesia in this surgery have shown a lower incidence of these side-effects. So, a prospective study compared these incidences with propofol (P) versus thiopental/halothane (T+H) anaesthesia. Propofol appears to be efficient in reducing postoperative vomiting but might be associated with more frequent OCR.

Topics: Adolescent; Bradycardia; Child; Child, Preschool; Halothane; Humans; Infant; Postoperative Complications; Propofol; Prospective Studies; Reflex, Oculocardiac; Strabismus; Thiopental; Vomiting

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

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

Topics: Anesthesia, Obstetrical; Anesthesiology; Birth Rate; Blood Gas Analysis; Blood Pressure; Female; Gallamine Triethiodide; Humans; Infant Mortality; Male; Maternal-Fetal Exchange; Pregnancy; Respiration; South Africa; Thiopental; Vomiting; Workforce

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

Topics: Anesthesia, Intravenous; Anxiety; Dreams; Female; Humans; Infusions, Parenteral; Ketamine; Thiopental; Vomiting

Topics: Anesthesia, Intravenous; Emergencies; Humans; Intubation, Intratracheal; Methods; Oxygen Inhalation Therapy; Succinylcholine; Surgical Procedures, Operative; Thiopental; Vomiting

Topics: Amnesia; Anesthesia, Intravenous; Benzodiazepinones; Blood Pressure; Cardiac Surgical Procedures; Depression, Chemical; Diazepam; Female; Heart Rate; Humans; Hysterectomy; Male; Muscles; Postoperative Complications; Sleep; Thiopental; Vomiting

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

Topics: Acidosis; Adolescent; Adult; Anesthesia; Anesthetics; Female; Halothane; Heart Arrest; Humans; Kidney Transplantation; Male; Middle Aged; Nitrous Oxide; Oxygen; Pulmonary Edema; Succinylcholine; Thiopental; Transplantation, Homologous; Tubocurarine; Vomiting

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

Topics: Anesthesia, Inhalation; Cyclopropanes; Ethyl Ethers; Female; Halothane; Humans; Postoperative Complications; Thiopental; Time Factors; Vomiting

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

Topics: Anesthesia, General; Anesthetics; Humans; Thiopental; Vomiting

Topics: Amnesia; Anesthesia, Intravenous; Blood Pressure; Diazepam; Female; Humans; Hysterectomy; Muscles; Postoperative Complications; Respiration; Thiopental; Uterine Cervical Neoplasms; Vomiting

Topics: Adolescent; Aged; Analgesics; Analgesics, Non-Narcotic; Anesthesia; Anesthesia, Inhalation; Antipyretics; Ether; Geriatrics; Humans; Intubation; Intubation, Intratracheal; Nitrous Oxide; Postoperative Complications; Postoperative Nausea and Vomiting; Preanesthetic Medication; Sex; Thiopental; Vomiting

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

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

Topics: Adjuvants, Anesthesia; Anesthesia; Anesthesia, Endotracheal; Anesthesiology; Humans; Succinylcholine; Thiopental; Vomiting

Topics: Anesthesia; Anesthesia, Intravenous; Anesthetics, Intravenous; Atropine; Barbiturates; Hexobarbital; Humans; Hypotension; Meperidine; Methohexital; Respiration; Thiopental; Toxicology; Vomiting