Thiamylal sodium increased inflammation and the proliferation of vascular smooth muscle cells / 대한마취과학회지

BACKGROUND: Thiamylal sodium is a common anesthetic barbiturate prepared in alkaline solution for clinical use. There is no previously reported study on the effects of barbiturates on the inflammation and proliferation of vascular smooth muscle cells (VSMCs). Here, we examined the effects of clinical-grade thiamylal sodium solution (TSS) on the inflammation and proliferation of rat VSMCs. METHODS: Expression levels of interleukin (IL)-1α, IL-1β, IL-6, and toll-like receptors in rat VSMCs were detected by quantitative reverse transcription-polymerase chain reaction and microarray analyses. The production of IL-6 by cultured VSMCs or ex vivo-cultured rat aortic segments was detected in supernatants by enzyme-linked immunosorbent assay. VSMC proliferation and viability were determined by the water-soluble tetrazolium-1 assay and trypan blue staining, respectively. RESULTS: TSS increased expression of IL-1α, IL-6, and TLR4 in VSMCs in a dose-dependent manner, and reduced IL-1β expression. Ex vivo TSS stimulation of rat aorta also increased IL-6. Low concentrations of TSS enhanced VSMC proliferation, while high concentrations reduced both cell proliferation and viability. Expression of IL-1 receptor antagonist, which regulates cell proliferation, was not increased by TSS stimulation. Exposure of cells to the TSS additive, sodium carbonate, resulted in significant upregulation of IL-1α and IL-6 mRNA levels, to a greater extent than TSS. CONCLUSIONS: TSS-induced proinflammatory cytokine production by VSMCs is caused by sodium carbonate. However, pure thiamylal sodium has an anti-inflammatory effect in VSMCs. TSS exposure to VSMCs may promote vascular inflammation, leading to the progression of atherosclerosis or in-stent restenosis, resulting in vessel bypass graft failure.

The comparative study between thiamylal sodium and thiopental sodium on the effectiveness and safety in induction of general anesthesia / 대한마취과학회지

This study was designed to evaluate the safety and efficacy of the new domestic product, Citosol(R) (thiamylal sodium) as an intravenous induction agent, by comparing with the most popularly used thiopental sodium in modern clinical anesthetic practice, and also to observe if there is any more harmful effect than thiopental sodium on the hemodynamic status of the patient. 60 patients who admitted to Seoul National University Hospital to receive operations at departments of E.N.T., Gynecology, and Ophthalmology, with ASA physical status 1 or 2, were randomly assigned to be given either thiamylal sodium, 3.4 mg/kg (n=30), or thiopental sodium, 5 mg/kg (n=30), intravenously, for induction, While administering 100% oxygen, patients were given vecuronium, 1,5 mg/kg, i.v., and intubated at the end of three minutes after administration of vecuronium. After intubation, anesthesia was maintained with 50% N2O. O2 and isoflurane. Both thiopental sodium and thiamylal sodium produced significant decrease in arterial pressure without significant increase in heart rate during mduction period. No disastrous complications were seen during the induction period with the use of either drug. Also there was no significant difference between two groups in the incidence of complications or in the changes of arterial pressure and heart rate except a statistically significant greater ineidence of pain on injection with the use of thiopental sodium. Above results suggest that thiamylal sodium and thiopental sodium are almost identical in their clinical actions and are both safe, and effective for use in the induction of patients but thiamylal sodium seems to have somewhat higher potency than thiopental sodium, and brings less pain during intravenous injection, which enables the induction more comfortable.

Effect of Thiopental and Thiamylal on Isolated Thoracic Aorta in Normotensive and Spontaneously Hypertensive Rats / 대한마취과학회지

The present study was undertaken to measure the effects of thiopental and thiamylal on isolated thoracic aortic hlical strips in normotensive Wistar rats(NWR) and spontaneously hypertensive rats(SHR). Phenylphrine(10(-9) ~ 10(-5) M) caused a dose-dependant contraction in thoracic aortic strips contracted with 30mM KCI in NWR and SHR. The contraction induced by 30mM KCI was taken as 100% and the mean absolute values of NWR and SHR were 463+/-30 and 457+/-38mg, respectively. The ED50 of phenylphrine in thoracic aortic strips contracted with 30mM KCI in NWR and SHR was (2.3+/-1.2) X 10(-8) M and (2.1+/-1.1) X 10(-9) M, respectively. There were no significant differences in the contractile response of thoracic aorta from NWR and SHR to 30mM KCI. In helically cut strips of thoracic aorts contracted with 30mM KCI, the cumulative administration of thiopental (10(-5) ~ 10(-3) M) caused a dose related contraction in NWR and SHR. The contraction induced by 30mM KCI was taken as 100% and the mean absolute values of NWR and SHR were 496+/-31 and 541+/-69mg, respectively. There were significant differences (p<0.05 and p<0.01) in the contractile responses of thoracic aorta from NWR and SHR to thiamylal(3X10(-4) and 10(-3) M). The dose-related contraction to thiamylal was greater than that to thiopental in NWR and SHR.