A Comparative Study of Single Breath Induction of Anaesthesia Using a Vital Capacity Breath of Halothane Nitrous Oxide and Oxygen Mixture with Intravenous Sodium Pentothal

Background: Induction of anaesthesia is accompanied byintravaneous sodium pentothal or inhalation of an appropriatemixture of Halothane, Nitrous oxide and oxygen.Aims and Objectives: 1) To study the vital capacity singlebreath induction using Halothane, Nitrous oxide and OxygenMixture. 2) To compare the efficiency and acceptance of abovemethod with i/v Sodium Pentothal induction.3) To access anycomplication arising from above technique.Methods: Patients were randomly divided in two equal of 25each belonging to ASA grade 1.Group A: Patient was given intravenous sodium Pentothal withan intravenous drip of 5% dextrose solution.Group B: Patients were given a mixture of 4% Halothane in66%N2o and 33% oxygen by using mapleson. A breathingsystem (Vital Capacity Breath)Results: It has been observed that there was no clinicallysignificant fluctuation in pulse rate and arterial pressure at anytime during induction. 1) No patient developed arrhythmiaduring induction in thiopentone group while one patient inhalothane group developed transient ventricular ectopic 1minute after starting the induction. 2) Except one patient whohad coughing during induction with thiopentone, induction wassmooth in all. Nausea and vomiting were more withthiopentone group as compared to halothane group. 3) The

Effect of various anesthetic induction agents on blood magnesium and calcium concentration / 대한마취과학회지

BACKGROUND: Decrease in blood magnesium and calcium concentration is associated with an increase in the incidence of arrhythmia, especially during the induction period. Therefore, it is important to evaluate the effects of propofol, pentothal sodium, and sevoflurane on calcium and magnesium concentration. METHODS: Thirty-six premedicated, ASA grade I patients were selected and randomly allocated into 3 groups. Six percent sevoflurane inhalation (sevo group), propofol 1.5 mg/kg (propofol group), and 5 mg/kg of pentothal sodium (pento group) were administered for anesthetic induction and anesthetic maintenance was done with end-tidal sevoflurane concentration at 3.5%. Blood sampling was performed during the pre-induction period (pre-induction), just before tracheal intubation (pre-intubation), and 2 min after intubation (post-intubation). pH corrected ionized magnesium and calcium were calculated and analyzed simultaneously. RESULTS: Both total calcium and magnesium concentrations decreased significantly in all groups during the pre-intubation and post-intubation periods compared with the pre-induction period. Ionized calcium only decreased significantly during pre-intubation and post-intubation in the pento group, and did not change throughout the study period in the sevo and propofol groups. Ionized magnesium did not change throughout the study period in any of the groups. pH corrected ionized calcium decreased significantly only at post-intubation in the pento group. CONCLUSIONS: All anesthetic induction agents administered in this study can be used safely in terms of magnesium-associated arrhythmia. However, ionized calcium concentration decreased in the pento group, but all values were within normal limits. This finding indicated that it is safe to use propofol, pentothal sodium, and sevoflurane for anesthetic induction

Hemorrhoidectomy Under Local Anesthesia after Pentothal Induction versus Spinal Anesthesia: a Concurrent Nonrandomized Prospective Study

PURPOSE: The aim of this study was to evaluate the effectiveness of local anesthesia compared to spinal anesthesia and the usefulness of pentothal induction before infiltration of a local anesthetic agent. METHODS: A concurrent non-randomized prospective study was conducted on 52 patients who underwent a hemorrhoidectomy. For the spinal anesthesia (SA) group (n=29), 0.5% heavy bupivacaine (Marcaine(R)), 5 mg (1 ml), was used, and for the local anesthesia (LA) group (n=23), pentothal, 3.3 mg/kg, was administrated intravenously prior to infiltration of a mixture of local anesthetics (2% lidocaine, 14 ml, with 0.5% bupivacaine, 7 ml). RESULTS: There were no differences between the two groups in terms of operating time, postoperative pain, headache, urinary difficulty, nausea or vomiting, pain-free interval after operation, analgesic requirements, and patient's or surgeon's satisfaction. Postoperative ambulation was earlier in the LA group than in the SA group. CONCLUSIONS: Local anesthesia after pentothal induction can be used effectively for a hemorrhoidectomy and may be a safe alternative to spinal anesthesia.

Cardiovascular change to endotracheal intubation during anesthetic induction with midazolam-fentanyl / 대한마취과학회지

Thiopental sodium, a water-soluble barbiturate derivative with pH 10.0, reaches brain tissue in its highest concentration in about 50 seconds after intravenous injection. Blood concentration then decreases according to redistribution. Patients who are given midazolam as an induction agent are known to awake from general anesthesia relatively more slowly than those given pentothal sodium. Fentanyl, a potent analgesic, has been used in balanced anesthesia because of its minimal cardiovascular effects. In the present study, the effects of pentothal sodium, midazolam and midazolam-fentanyl on cardiovascular changes to endotracheal intubation during anesthetic induction were compared. Sixty patients of ASA class I or II scheduled to undergo elective operations were classified randomly into 3 groups. Group I and II were injected with thiopental sodium 5.0 mg/kg and midazolam 0.2 mg/kg, respectively. Group III received midazolam 0.1 mg/kg and fentanyl 2 ug/kg. The results were as follows ; 1) The onset time (time from intravenous injection to loss of eyelid reflex) of group III (137+/-10.29 seconds, p<0.05) was longer than those of group I (10+/-3.22 seconds) and group II (37+/-12.49 seconds). 2) The change of the mean arterial pressure : Group III showed minimal change (4% decrease, p<0.05) at 1 minute after endotracheal intubation as compared with group I (21% increase) and group II (6% increase). 3) The change of the heart rate ; Group III showed the least change (6% increase, p<0.05) at 1 minute after endotracheal intubation as compared with group I (18% increase) and group II (12% increase). From these results, it is suggested that the combined use of midazolam and fentanyl may cause less effect on the cardiovascular system during endotracheal intubation than midazolam or thiopental sodium alone.

Clinical Effects of Propofol According to Dosage / 대한마취과학회지

Propofol(Diprivan, England ICI) is a new intravenous anesthetic agent chemically unrelated to barbiturates or other intravenous anesthetic agents. It was found to produce rapid onset of anesthesia and early recovery similar to that Obtained with pentothal sodium. The purpose of the present study is to compare the cardiovascular and respiratory effect of propofol with the cardiovaseular and respiratery effeet of pentothal sodium. Sixty patients of ASA class l or 2 scheduled to undergo gynecological, orthopedic and abdominal procedures were classified randomly into 3 Groups. Group A were injected with pentothal sodium 5.0 mg/kg and Group B, C received propofol 2.0 mg/kg, 2.5 mg/kg respectively. The results were as follows, 1) Change of the systolic arterial pressure. Propofol 2.5 mg/kg produced the greatest decrease in systolic blood pressure when compared with other groups. 2) Change of the heart rate. Change of the heart rate was minimal after both doses of prepofol when compared with pentothal sodium. 3) Respiratory effect. Respiratory measurement in 20 unpremedicated surgical patients who received an induction dose of propofol 2.5 mg/kg showed significant respiratory depression. 4) Side effect. Excitatory effects and pain on injection were more frequent in propofol group than pentothal sodium group. Nausea, vomiting were more frequent in pentothal sodium group than propofol group.