Effects of thiopental sodium, ketamine, and propofol on the onset time of rocuronium in children

BACKGROUND: In emergency condition, failure in securing airway is a common and serious reason of pediatric death. Rapid intubation is required to minimize physiologic complication in children due to airway failure. Rapid loss of consciousness and rapid onset of neuromuscular blocking agent are necessary for the rapid sequence intubation. In this study, we compared the effects of thiopental sodium, ketamine, and propofol (drugs commonly used to induce anesthesia in children) on the onset time of rocuronium. We also compared the effects of these anesthesia induction drugs on intubation condition and their duration of action. METHODS: A total of 89 patients undergoing various elective surgeries were enrolled and allocated to the following three groups according to the anesthesia induction drug: 1) Group T, thiopental sodium; 2) Group P, propofol; and 3) Group K, ketamine. After loss of consciousness, neuromuscular monitoring was performed and rocurunium 0.6 mg/kg was administered. Onset time and duration of action of rocuronium were measured. Intubation condition was recorded with a tracheal intubation scoring system. Hemodynamic changes were observed before induction until 5 min after endotracheal intubation. RESULTS: The onset time of rocuronium in group K (39.9 s) was significantly faster than that in group T (61.7 s) or group P (50.7 s). There was no significant difference in duration of action of rocuronium or intubation condition among the three groups. CONCLUSIONS: Ketamine can decrease the onset time of rocuronium significantly compared to thiopental sodium or propofol.

Comparative study to evaluate anesthetic effect of Thiopentone Sodium and Propofol in electroconvulsive therapy.

Introduction: In therapeutic management of psychiatric illness the response to electroconvulsive therapy may be attenuated if anesthesia that is used abolishes or inhibits seizures. Anesthetic agents used for electroconvulsive therapy should provided smooth and rapid induction, a rapid recovery, minimal alteration of the physiological effects of electroconvulsive therapy as well as minimal antagonistic effects on seizure activity. Material and methods: In study of 120 patients with ASA grade I or II, having indication for Electroconvulsive therapy, half were randomly anaesthetized by 2.5% Thiopental Sodium with dose 3 mg/kg (Group I) and 1% Propofol in 1.5 mg/kg dose (Group II). A current of 110 volts was psychiatrist. Pulse and Blood pressure monitoring and Seizure response were evaluated along with side effects if any. Observation: After Induction, systolic BP in the 2 Groups did not show any significant (p>0.05) difference while the diastolic BP was significantly (p<0.05) lower in the propofol group. After suxamethonium systolic and diastolic BP were significantly (p<0.05) decreased in the propofol group. After completion of seizure systolic BP came down to basal level at 10 mins and diastolic BP came down to basal level at 15 mins. While in the thiopentone sodium group, the BP did not come down even the end of 15 mins. The duration of seizure activity in the propofol group was markedly reduced (p<0.05) as compared to the thiopentone sodium group. The time from induction to eye opening and induction to walking unaided were significantly (p<0.001) lower in the propofol groups suggesting faster recovery. During induction, higher percentage of patients showed discomfort on injection in the propofol group while during recovery headache, nausea and vomiting were noted in more patients within thiopentone group. Conclusion: Propofol group compared to thiopentone sodium had reduced increase in BP and pulse rate, reduced duration of seizure activity. Recovery was faster and side effects were reduced during recovery.

Anesthetic efficacy of etomidate, propofol and thiopental sodium during electroconvulsive therapy

BACKGROUND: Electroconvulsive therapy (ECT) is effective for major psychosis and affective disorder. The ideal anesthetics for ECT provide rapid induction and recovery, and they attenuate the adverse effects of ECT. We compared the effects of etomidate, propofol and thiopental sodium during ECT. METHODS: Nine patients were enrolled in this double blinded cross over design study. The ECT was done 3 times per week for two weeks. We monitored the patients with electrocardiography, pulse oximetry, the bispectral index score and the blood pressure. We recorded the data at the time of arrival to the therapy room, just before ECT and at 1, 2, 3, 4, 5, 7 and 10 minutes after ECT. Hypnosis was induced with 3 mg/kg of thiopental sodium (group T), 1.5 mg/kg of propofol (group P) or 0.15 mg/kg of etomidate (group E). The ECT was done after administering 1 mg/kg of succinylcholine. The duration of seizure were measured after ECT. RESULTS: There were significantly different durations of motor seizure among the three groups. The duration of EEG seizure in group E was longer than that of group P and group T. The blood pressure and the heart rate of group P were significantly lower than that of the other groups (P < 0.05). CONCLUSIONS: Compared to thiopental sodium and etomidate, propofol was not associated with clinically significant changes in the duration of seizure and hemodynamic stability. It has a good hypnotic effect and it did not affect the therapeutic efficacy of ECT. Etomidate is effective for patients for achieving a short duration of seizure after ECT is applied.

Effect of ketamine versus thiopental sodium anesthetic induction and a small dose of fentanyl on emergence agitation after sevoflurane anesthesia in children undergoing brief ophthalmic surgery / 대한마취과학회지

BACKGROUND: Emergence agitation (EA) in children after sevoflurane anesthesia is common. The purpose of this study was to compare the incidences of EA between ketamine and thiopental sodium induction in children underwent sevoflurane anesthesia. We also evaluated if a small dose of fentanyl could reduce the incidence of EA. METHODS: The patients who were scheduled for strabismus or entropion surgery were divided into 4 groups. The patients in Groups 1 and 2 were induced anesthesia with ketamine 1.5 mg/kg; those in Groups 3 and 4 were induced with thiopental sodium 5 mg/kg. The patients in Groups 1 and 3 received an injection of fentanyl 1.5 microgram/kg, whereas the patients in Groups 2 and 4 received IV saline of the same volume. Anesthesia was maintained with sevoflurane. The recovery characteristics and EA in recovery room were assessed. RESULTS: The incidence of EA was significantly higher in Groups 2 and 4 and there was no difference between Groups 2 and 4. Group 2 had almost an eleven-fold higher risk of developing EA than did Group 1, and the incidence of EA in Group 4 was sixty-nine-fold higher than that of Group 1. The risk factor for EA was only the kind of medication. Preoperative anxiety had no significant correlation with EA. CONCLUSIONS: The incidence of EA after sevoflurane anesthesia is similar between ketamine and thiopental sodium anesthetic induction in children undergoing pediatric ophthalmic surgery. Also, the addition of a small dose of fentanyl after anesthetic induction decreases the incidence of EA.

Effect of ketamine versus thiopental sodium anesthetic induction and a small dose of fentanyl on emergence agitation after sevoflurane anesthesia in children undergoing brief ophthalmic surgery / 대한마취과학회지

BACKGROUND: Emergence agitation (EA) in children after sevoflurane anesthesia is common. The purpose of this study was to compare the incidences of EA between ketamine and thiopental sodium induction in children underwent sevoflurane anesthesia. We also evaluated if a small dose of fentanyl could reduce the incidence of EA. METHODS: The patients who were scheduled for strabismus or entropion surgery were divided into 4 groups. The patients in Groups 1 and 2 were induced anesthesia with ketamine 1.5 mg/kg; those in Groups 3 and 4 were induced with thiopental sodium 5 mg/kg. The patients in Groups 1 and 3 received an injection of fentanyl 1.5 microgram/kg, whereas the patients in Groups 2 and 4 received IV saline of the same volume. Anesthesia was maintained with sevoflurane. The recovery characteristics and EA in recovery room were assessed. RESULTS: The incidence of EA was significantly higher in Groups 2 and 4 and there was no difference between Groups 2 and 4. Group 2 had almost an eleven-fold higher risk of developing EA than did Group 1, and the incidence of EA in Group 4 was sixty-nine-fold higher than that of Group 1. The risk factor for EA was only the kind of medication. Preoperative anxiety had no significant correlation with EA. CONCLUSIONS: The incidence of EA after sevoflurane anesthesia is similar between ketamine and thiopental sodium anesthetic induction in children undergoing pediatric ophthalmic surgery. Also, the addition of a small dose of fentanyl after anesthetic induction decreases the incidence of EA.

Comparing the effects of thiopental and propofol administration on the cardiovascular response as an induction agent during desflurane anesthesia

BACKGROUND: This study was undertaken to compare the hemodynamic effects of thiopental and propofol administration as induction agents during desflurane anesthesia. METHODS: One hundred twenty unpremedicated ASA physical status 1 patients who were aged 20-60 years and who scheduled for elective surgery under general anesthesia were randomly divided into two groups. In group T, thiopental sodium (5 mg/kg) was used to induce anesthesia, whereas propofol (2.5 mg/kg) was used in group P. In each group, the inspired concentration of desflurane was increased to 4.0 vol% shortly after a thiopental or propofol injection. After 10 manual baggings, the target was increased to produce an end-tidal concentration of desflurane (ETdesf) of 8.0 vol%, and this was maintained until the end of the study by adjusting the vaporizer setting. The heart rate (HR) and mean arterial pressure (MAP) were measured at baseline, 2 min and 5 min after induction and at 2 min after intubation. RESULTS: The heart rate was significantly increased in the two groups compared with baseline. In the P group, the mean blood pressure was decreased at 2 and 5 min after induction compared with baseline, whereas the mean blood pressure in the T group was significantly increased after induction. The mean blood pressure was significantly lower in group P than that in group T at 2 and 5 min after the injection of the induction agent. However, the heart rate did not differ significantly between two groups. CONCLUSIONS: During desflurane anesthesia, the heart rate did not differ significantly between the two groups, yet the mean blood pressure was significantly lower when using propofol than that when using thiopental sodium.

Resolution of atrial fibrillation with induction of general anesthesia: A case report

Atrial fibrillation is one of the most common arrhythmias in everyday life, and it is responsible for substantial mortality and morbidity in the general population.When atrial fibrillation is first noticed and it persists for a long time, it will be more difficulty to control and it will recur more often.A 58-year old female patient was scheduled for surgery due to the increased size of an intracranial arteriovenous malformation.During the preparation of anesthesia, we noticed the presence of atrial fibrillation.After about 2 hours of sedation and consultation, we decide to proceed with the surgery. With the induction of anesthesia by using thiopental sodium, we observed the rapid conversion of atrial fibrillation to sinus tachycardia.During the maintenance of anesthesia, the patient showed normal sinus rhythm and the surgery was completed without complications.

A comparison of hemodynamics in elderly patients that were administered thiopental sodium or propofol to induce general anesthesia / 대한마취과학회지

BACKGROUND: Thiopental sodium and propofol are commonly used to induce anesthesia. This study was conducted to compare the hemodynamic effects of propofol and thiopental sodium during the induction of general anesthesia in elderly patients. METHODS: Forty patients undergoing general anesthesia were randomly divided into two groups. In group T, thiopental sodium was used to induce anesthesia, whereas propofol was used in group P. Hemodynamic changes in the mean blood pressure, heart rate, cardiac index (as determined using a NICCOMO monitor) and bispectral index (BIS) during induction were then compared between the two groups. In addition, the dosage of induction agent, time required until loss of response to verbal order (LOV) and eyelid reflex were compared between groups. RESULTS: The mean blood pressure was significantly lower in group P than in group T during the 1-5 min following LOV and during the 2, 3 min following intubation (P < 0.05). However, the heart rate did not differ significantly between the two groups. The cardiac index also did not differ significantly between groups, except during the first 3 min following LOV. Finally, the BIS value were significantly lower than the baseline values in both groups during induction. CONCLUSIONS: In elderly patients, the heart rate, cardiac index and BIS value did not differ significantly between the two groups. But the mean blood pressure was significantly lower in propofol than in thiopental sodium.

Anaphylactic Reaction after Thiopental Sodium Injection -A case report- / 대한마취과학회지

A 43-year-old female was admitted for a laparoscopic surgical procedure. Her past history included two uneventful general anesthesias, but anaphylactic shock due to an unknown drug occurred during her third surgery. Induction was performed with thiopental sodium, but an immediate anaphylactic reaction developed with cardiovascular collapse. We resuscitated the patient and she recovered without any complication.

Intubating Conditions and Hemodynamic Changes according to Induction Agent and Tracheal Intubation Time after Rocuronium / 대한마취과학회지

BACKGROUND: Intubating conditions would be excellent and hemodynamic variables would be relatively stable during rapid- sequence anesthesia induction if tracheal intubation was performed at a proper time. The purpose of this study was to identify the ideal intubation time after rocuronium with either thiopental or propofol. METHODS: 113 patients, ASA physical status I or II, were randomly divided into four groups. Patients in group TR60 (thiopental-rocuronium) and in group PR60 (propofol-rocuronium) were intubated within 60 s, while groups TR90 and PR90 were intubated within 90 s after the administration of rocuronium. Intubating conditions were graded by an experienced anesthesiologist, and hemodynamic variables were noted just before induction (baseline), immediate after induction, immediate after intubation, and 5 min after intubation. RESULTS: Clinically acceptable intubating conditions (good or excellent) were not statistically different among the four groups. However, 55 and 64% of patients in groups TR90 and PR90, respectively, had excellent intubating conditions compared to only 39 and 38% in groups TR60 and PR60 (P < 0.05). Mean arterial pressure and rate pressure product (RPP) immediately after intubation were relatively stable in groups TR90 and PR90 compared to those in groups TR60 and PR60 (P < 0.05). CONCLUSIONS: The intubation time after rocuronium, rather than the choice of induction agent, is the deciding factor affecting intubating conditions and hemodynamic variables during rapid-sequence anesthesia induction. Ninety seconds after the administration of rocuronium with either thiopental or propofol might be an ideal intubation time.

Effects of Etomidate, Thiopental Sodium and Propofol on Intraocular Pressure Associated with Tracheal Intubation / 대한마취과학회지

BACKGROUND: During ophthalmologic surgery, various intravenous anesthetic induction agents are used to prevent an intraocular pressure (IOP) increase. This study was designed to compare the effects of etomidate on IOP with those of thiopental sodium and propofol in patients receiving vecronium bromide, and in whom tracheal intubation was performed. METHODS: Forty-five patients undergoing elective surgery were ramdomized to receive etomidate 0.3 mg/kg (E group, n = 15), thiopental sodium 5 mg/kg (T group, n = 15) or propofol 2.5 mg/kg (P group, n = 15). IOP, systolic arterial pressure (SAP) and heart rate (HR) were measured before induction (B), after the adminstration of the induction agents (I1), before intubation (I2) and at 1, 2 and 3 mins after intubation (T1, T2 and T3). RESULTS: The IOP after I1 and I2 in the E , T and P groups were significantly lower than in group B (P < 0.05). The IOP at T1, T2 and T3 in the E, T and P groups were not found to be significantly different from group B. The IOP, SAP and HR at T1, T2, and T3 in the E, T and P groups were significantly higher than at I1 and I2 (P < 0.05). No significant differences were observed between the groups in term of IOP. The SAP and HR at T1, T2 and T3 in the P group were significantly lower than in the other two groups (P < 0.05). CONCLUSIONS: We concluded that etomidate, thiopental sodium and propofol may be useful induction agents for general anesthesia in ophthalmologic surgery but that they do not prevent IOP elevation during endotracheal intubation.

Effect of Thiopental Sodium on Hearing Outcomes Following Microvascular Decompression Surgery / 대한마취과학회지

BACKGROUND: The use of intraoperative brainstem auditory evoked potential (BAEP) has reduced the incidence of sensorineural hearing loss (SNHL) after microvascular decompression (MVD). This complication occurs due to direct compressive and/or stretching injury of the cochlear nerve or to indirect compression of the perineural vasculature during cerebellar retraction. The aim of this study was to evaluate the effect of thiopental sodium on SNHL after MVD for hemifacial spasm. METHODS: 94 hemifacial spasm patients with normal hearing function preoperatively and who underwent MVD under intraoperative BAEP monitoring were enrolled in this study. Patients were randomly divided into two groups. 52 patients were administered placebo (control group) and 42 patients were administered thiopental sodium 5 mg/kg intravenously 5 minutes before cerebellar retraction (thiopental group). The effects of thiopental on intraoperative BAEP changes and postoperative hearing functional outcomes were sought. Incidence and degree of postoperative SNHL were evaluated by pure tone audiometry threshold analysis. RESULTS: Maximal changes in intraoperative BAEP parameters did not differ between the two groups, and neither did the incidence nor degree of SNHL. In the control group, 4 transient and 4 permanent postoperative SNHL, including 2 deaf patients, occurred with an overall incidence of 15.4%. In the thiopental group, 2 transient and 1 permanent postoperative SNHL occurred, with an overall incidence of 7.1%. CONCLUSIONS: Thiopental sodium administered prior to cerebellar retraction might reduce the incidence of postoperative hearing loss.

Comparison of Emergence Agitation from Sevoflurane Anesthesia in Propofol or Thiopental Sodium Induction / 대한마취과학회지

BACKGROUND: Sevoflurane, with its low pungency, rapid emergence and recovery, is an attractive anesthetic in paediatric anesthesia, but the high incidence of postoperative agitation represents a problem. Propofol-anesthesia is recognised for its rapid and clear-headed emergence. We tested the hypothesis that the maintenance of anesthesia with sevoflurane after propofol induction reduces the incidence of excitatory behavior compared with thiopental sodium induction. METHODS: Children aged 4-10 years, undergoing elective tonsillectomy, were randomly assigned to receive propofol 2.5 mg/kg (Group P) or thiopental sodium 5 mg/kg (Group T) for induction. After loss of consciousness, tracheal intubation was performed with rocuronium 0.6 mg/kg and all patients received sevoflurane (2-3 vol.%)-N2O (2 L/min)-O2 (2 L/min) for anesthesia maintenance. Ventilation was controlled to maintain normocarpnia. At the end of surgery, sevoflurane and N2O were discontinued and muscle relaxant was reversed. Extubation time, agitation grade in recovery room, postoperative side effects and time in the recovery room were checked and compared between the two groups. RESULTS: Time to extubation (6.84+/-1.57 vs 8.48+/-1.05 min), discharge from the recovery room(33.7+/-3.9 vs 55.0+/-7.9 min) and emergence agitation incidence (8% vs 92%) were significantly different in Group P and Group T, respectively (P < 0.05). The incidence of nausea and vomiting was not significantly different (4% vs 16%). CONCLUSIONS: Emergence agitation after sevoflurane anesthesia was significantly reduced by propofol induction compared with thiopental sodium.

Effects of Intravenous Induction Drugs on Intubation Conditions Using Rocuronium for Rapid Sequence Induction / 대한마취과학회지

BACKGROUND: We assessed the effect of intravenous induction agents on intubation conditions and hemodynamic changes when using rocuronium 0.7 mg/kg for rapid sequence induction. METHODS: Sixty ASA class I or II patients undergoing elective surgery were divided into a thiopental group (5 mg/kg, n = 20), a propofol group (2 mg/kg, n = 20) and an etomidate group (0.2 mg/kg, n = 20). Anesthesia was induced with intravenous induction agents. After loss of consciousness, rocuronium 0.7 mg/kg was injected. Intubation was attempted at 60 seconds after rocuronium administration. Arterial blood pressure and heart rate were measured before induction, immediately after intubation, and 1, 3, 5, and 10 minutes after intubation. Intubation conditions were assessed by jaw relaxation, vocal cord movement, response to tracheal intubation, and were evaluated as excellent, good, fair, and poor. RESULTS: Excellent intubation conditions were obtained 55% (n = 11) in the thiopental group, 60% (n = 12) in the propofol group, and 45% (n = 9) in the etomidate group. Systolic and diastolic arterial blood pressures were elevated after intubation in all three groups. But these changes were minimal in the propofol group. CONCLUSIONS: Intubation conditions were not significantly different after the intravenous injection of thiopental 5 mg/kg, propofol 2mg/kg, or etomidate 0.2 mg/kg when using rocuronium 0.7 mg/kg for rapid sequence induction.

The Effect of Cranial Pin Insertion on Blood Pressure and Heart Rate after Injecting Fentanyl and Esmolol or Thiopental Sodium and Esmolol / 대한마취과학회지

BACKGROUND: The placement of cranial pins into the periosteum is a acute noxious stimulation during intracranial surgery, which can result in sudden increases in blood pressure and heart rate, causing increases in intracranial pressure and other hemodynamic responses. We compared blood pressures and heart rates after injecting fentanyl and esmolol or thiopental sodium and esmolol to blunt hypertensive response. METHODS: Forty patients scheduled for a craniotomy were randomly divided into two groups: Intravenous (I.V.) bolus of fentanyl and esmolol group (n = 20) and the thiopental sodium and esmolol group (n = 20). After inducing general anesthesia with sevoflurane, nitrous oxide 50% and oxygen, an IV. bolus of either fentanyl and esmolol or thiopental sodium and esmolol was administered 2 minutes prior to the insertion of the cranial pin. Hemodynamic variables (systolic, diastolic, mean arterial pressure, and heart rate) were measured at 6 different time points; at baseline (drug administration), just before pinning, and at 30 seconds, and 1, 2, and 3 min after pinning. RESULTS: The fentanyl and esmolol group showed lower blood pressure and heart rate increases than the thiopental sodium and esmolol group at 30 sec and 1 min after cranial pin insertion compared with just before pinning. CONCLUSIONS: We conclude that I.V. fentanyl and esmolol 2 minutes prior to cranial pinning is more effective than I.V. thiopental sodium and esmolol at reducing blood pressure and heart rateincreases after cranial pinning.

Comparison of Bispectral Index at Each Thiopental Sodium Induction Dose / 대한마취과학회지

BACKGROUND: Thiopental sodium is one of the most commonly used intravenous anesthetics, but there exists no reliable report of BIS that can predict the hypnotic state. Our purpose was to compare BIS values after administering different doses of thiopental sodium. METHODS: With institutional review board approval and informed consent, sixty adult patients scheduled for elective surgery were studied. The patients were divided into three groups according to induction doses as follows: group 1: 3 mg/kg, group 2: 4 mg/kg, group 3: 5 mg/kg. After induction the BIS was monitored at 15 second intervals to 90 seconds. The number of patients with a BIS of less than 55 was recorded. RESULTS: The BIS at baseline and 15 seconds after administration were not statistically different in the three groups. The BIS at 30 seconds in group 1 differed from those of groups 2 and 3, but all of the mean BIS values were more than 55. The BIS values at 45 and 90 seconds were statistically different for three groups, and the mean BIS values of groups 2 and 3 were less than 55. The number of patients with a BIS of less than 55 at any point was eight in group 1, and twenty in groups 2 and 3. CONCLUSIONS: BIS monitoring suggests that a dosage above 4 mg/kg of thiopental sodium is sufficient for the reliable induction of anesthesia.

Comparisons between Etomidate and Thiopental Sodium as an Induction Agent of General Anesthesia in Elderly Patients / 대한마취과학회지

BACKGROUND: This study was designed to determine whether etomidate-based induction can provide better hemodynamics than a standard thiopental sodium-based anesthetic induction in elderly patients. METHODS: Sixty ASA physical status 1 or 2 elderly patients scheduled for elective surgery were randomly allocated into one of three groups (Group 1; thiopental sodium, Group 2; etomidate, Group 3; pre-treatment with 0.02 mg/kg of midazolam and etomidate). We measured and compared hemodynamic changes (mean arterial pressure, heart rate), the doses of thiopental sodium and etomidate for loss of consciousness, the incidence and grade of myoclonus, and the bispectral index during induction of anesthesia. RESULTS: There were no significant differences in mean arterial pressure and heart rate among the three groups. Myoclonus occurred in 45% of patients receiving etomidate, 40% of patients receiving midazolam pre-treatment and etomidate. Pre-treatment of midazolam reduced the dose of etomidate for loss of consciousness by 20% in Group 3. The values of BIS decreased significantly from 1 minute after infusion of thiopental and etomidate, and reached 56.9 +/- 12.3 in group 1, 41.8 +/- 9.1 in group 2, and 45.8 +/- 8.5 in group 3 just before endotracheal intubation. CONCLUSIONS: These results indicate that there is no significant difference between etomidate and thiopental sodium as anesthetic induction agents in elderly patients. Pre-treatment with a small dose of midazolam reduced the dose of etomidate for loss of consciousness, but did not affect the incidence of myoclonus and hemodynamic changes during induction of anesthesia with etomidate.

The Effect of Propofol (2,6-diisopropylphenol) and Thiopental Sodium on Fertilization and Early Embryo Development in Mouse IVF Model / 대한마취과학회지

BACKGROUND: Propofol and thiopental sodium are short acting drugs and used as intravenous anesthetics for oocyte retrieval. Anesthetics administered during oocyte retrieval can pass into the follicular fluids and exert a detrimental effect on oocyte fertilizability. The aim of this study was to investigate the exposed concentration and time effect of these drugs on fertilization and early embryo development in a mouse in vitro fertilization (IVF) model. METHODS: Mouse oocytes were exposed in vitro to propofol at 0 (control), 0.09, 0.45, 2.3, 4.5microgram/ml and thiopental sodium at 0 (control), 0.2, 1, 5, 10microgram/ml for 10, 30, 60 minutes, washed, and inseminated. Thereafter, fertilization was assessed. Subsequent in vitro development to the hatched embryo was monitored daily. RESULTS: We found a concentration and time dependent toxic effect of propofol on the fertilizability of oocytes and early embryo development. The fertilization rate of mouse oocytes exposed for 30 minutes to medium containing 0.09microgram/ml of propofol was significantly lower than the control. The fertilization and hatching rate of mouse oocytes exposed for 10 minutes to medium containing 0.45microgram/ml of propofol was not lower than the control. We did not find a toxic effect of thiopental sodium on fertilization, but the hatching rate of fertilized oocytes exposed to medium containing thiopental sodium was significantly lower than the control. CONCLUSIONS: We suggest that the oocyte retrieval procedure should be done as quickly as possible in order to limit the toxic effect of these anesthetics.

Comparison of Thiopental Sodium and Propofol as an Induction Agent in Propofol-N2O Anesthesia for Cesarean Sections / 대한마취과학회지

BACKGROUND: We compared thiopental sodium with propofol as induction agents under propofol-N2O anesthesia for cesarean sections. METHODS: We selected 68 pregnant women with a single fetus undergoing an elective cesarean section under general anesthesia and randomly allocated them to the thiopental sodium group (group N) or the propofol group (group P). Without premedication, thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg were injected for induction in group N, and propofol 2 mg/kg and succinylcholine 1 mg/kg in group P. Propofol 10 mg/kg/hr was infused continuously with 50% N2O in both groups. We checked the blood pressure and the heart rate before and after injection. We analysed blood gas of maternal artery, umbilical artery, and umbilical vein at delivery and checked Apgar scores at 1 minute and 5 minutes after delivery. RESULTS: There was no significant difference in blood pressure, heart rate and Apgar scores between groups. Oxygen partial pressure (35.6 +/- 5.8 mmHg) and oxygen saturation (66.2 +/- 12.0%) of the umbilical vein in group P was higher than in group N (32.7 +/- 4.9 mmHg, 58.7 +/- 11.5%). Carbon dioxide partial pressure and pH did not differ between groups. CONCLUSIONS: There was no beneficial effect of thiopental sodium compared with propofol as an induction agent under propofol anesthesia. Propofol is a useful drug for cesarean sections.

Effects of Etomidate, Propofol and Thiopental Sodium on Intraocular Pressure during the Induction of Anesthesia / 대한마취과학회지

BACKGROUND: During ophthalmologic surgery, a variety of anesthetic induction techniques are used in an attempt to prevent the rise of intraocular pressure (IOP). This study compared the effects of etomidate, a new intravenous anesthetic agent, on the changes in IOP with those of thiopental sodium and propofol. METHODS: Forty-five patients were randomly allocated and divided into three groups to be injected intravenously with etomidate 0.2-0.3 mg/kg (E-group, n = 15), propofol 2-3 mg/kg (P-group, n = 15) or thiopental sodium 4-5 mg/kg (T-group, n = 15). Systolic arterial pressure (SAP), heart rate (HR) and intraocular pressure (IOP) were measured at 1, 2 and 3 minutes after the administration of the induction agents. During the induction of anesthesia, the incidence of IV injection pain, myoclonus, hiccup and a decrease in SAP of more than 30% were investigated. RESULTS: At 1, 2 and 3 min following the induction of anesthesia, the SAP in the P-Group decreased significantly more than that in the other two groups (P < 0.05). After the induction, heart rate in the T-Group increased significantly more than that in the other two groups (P < 0.05). The three intravenous agents induced a significant decrease in IOP after an injection (P < 0.05). Comparing the three groups, the IOP in the E- and P-Group decreased significantly more than that in the T-Group (P < 0.05). CONCLUSIONS: Etomidate may be used as a choice of intravenous induction agent to reduce intraocular pressure in ophthalmologic operations especially in an emergency situation, geriatric and hypovolemic patients.