Effect of different anesthetic agents on left ventricular systolic function assessed by echocardiography in hamsters

Determination of left ventricular ejection fraction (LVEF) using in vivo imaging is the cardiac functional parameter most frequently employed in preclinical research. However, there is considerable conflict regarding the effects of anesthetic agents on LVEF. This study aimed at assessing the effects of various anesthetic agents on LVEF in hamsters using transthoracic echocardiography. Twelve female hamsters were submitted to echocardiography imaging separated by 1-week intervals under the following conditions: 1) conscious animals, 2) animals anesthetized with isoflurane (inhaled ISO, 3 L/min), 3) animals anesthetized with thiopental (TP, 50 mg/kg, intraperitoneal), and 4) animals anesthetized with 100 mg/kg ketamine plus 10 mg/kg xylazine injected intramuscularly (K/X). LVEF obtained under the effect of anesthetics (ISO=62.2±3.1%, TP=66.2±2.7% and K/X=75.8±1.6%) was significantly lower than that obtained in conscious animals (87.5±1.7%, P<0.0001). The K/X combination elicited significantly higher LVEF values compared to ISO (P<0.001) and TP (P<0.05). K/X was associated with a lower dispersion of individual LVEF values compared to the other anesthetics. Under K/X, the left ventricular end diastolic diameter (LVdD) was increased (0.60±0.01 cm) compared to conscious animals (0.41±0.02 cm), ISO (0.51±0.02 cm), and TP (0.55±0.01 cm), P<0.0001. The heart rate observed with K/X was significantly lower than in the remaining conditions. These results indicate that the K/X combination may be the best anesthetic option for the in vivo assessment of cardiac systolic function in hamsters, being associated with a lower LVEF reduction compared to the other agents and showing values closer to those of conscious animals with a lower dispersion of results.

Two forgotten induction agents; etomidate versus thiopental sodium with rocuronium for rapid sequence induction

To assess the effect on intubating conditions and haemodynamic response on intubation of two different induction agents etomidate and thiopental sodium with rocuronium during rapid sequence induction. This prospective quasi experimentalstudy was conducted in Department Of Anaesthesia, SICU and Pain Management, Dow Medical College, Civil Hospital Karachi and Abbasi Shaheed Hospital Karachi Medical and Dental College over a period of one year. Total 120 American Society of Anaesthesiologists [ASA] physical class I and II, adult patients of either gender, aged between 18 to 60 years, undergoing elective surgery were allocated randomly into two equal groups to receive either intravenous thiopental sodium [Group NTR] or etomidate[Group NER] for rapid sequence induction. Group NER was given nalbuphine 0.1 mg/kg, induction agent etomidate 3 mg/kg with muscle relaxant rocuronium 1.0 mg/kg while in group NTR induction agent thiopental sodium was given in the dose of 4 mg/kg with nalbuphine and rocuronium in the same doses. After sixty seconds, laryngoscopy was done. Intubating condition was assessed using the criteria of Cooper and colleagues: ease of intubation, condition of vocal cords and response to intubation. Cardiovascular response on intubation in terms of systolic and diastolic blood pressure and heart rate was evaluated at 0,1, 3 and 5 minutes. Demographic data were comparable between the groups. Intubating conditions which were assessed in terms of ease of laryngoscopy, condition of vocal cords at intubation and intubation response coughing, bucking and diaphragmatic movement were significantly better in the group NER [p<0.05]. Similarly, arterial blood pressure remained close to base line in NER group but there was significant fall in both systolic and diastolic blood pressure in group NTR. However, there was no significant difference in change in the heart rate in the groups. Etomidate-rocuronium is better than thiopental-rocuronium in terms of intubating conditions and haemodynamic stability during rapid sequence induction in non-septic surgical patients in emergency department

[Comparison of Propofol with Thiopental in hemodynamic changes and apnea duration in intensive care units for intubation of trachea]

Use of drugs with short apnea duration and less hemodynamic changes for intubation of trachea in intensive care units is necessary. This study compares the effects of propofol and sodium thiopental on hemodynamic changes and apnea duration after tracheal intubation in patients admitted to intensive care units. In this double blind clinical trial, 25 ICU-admitted patients were evaluated. They were intubated two times with 72 hours interval, once received 1.5mg/kg sodium thiopental, and the other time 0.75 mg/kg propofol, while the drug used for intubation in the first time was randomly selected. Hemodynamic variables include systolic and diastolic BP, heart rate, MAP, RPP, MAP/HR and apnea duration in two times, during pre intubation, intubation and after intubation were measured. Data were analyzed with statistical tests of independent's t and ANOVA repeated test. In comparison with pre-intubation, hemodynamic variables such as systolic and diastolic BP, MAP and MAP/HR were decreased during tracheal intubation in both groups, but range of changes in propofol group is less than those of thiopental group and the difference is statistically significant [P<0.0001]. In comparison with thiopental, Propofol has fewer changes in hemodynamics in patients who needed tracheal intubation, and also has shorter apnea period. Accordingly use of propofol over thiopental is recommended for tracheal intubation in ICU patients

Estudio de los efectos de la asociación Ketamina-tiopental como co-inductores en los distintos periodos de la anestesia general / Study of the effects of ketamine-thiopental partnership as co-inducers in different periods of general anesthesia

La asociación de drogas tiene como finalidad potenciar efectos benéficos y disminuir reacciones adversas, esta investigación pretendió demostrar los efectos de la asociación de Tiopental sódico mas ketamina en dosis subterapeuticas, comparándola con Tiopental sódico en la inducción de la anestesia general para colecistectomías electivas y de urgencia, enfocando el efecto en la analgesia posoperatoria en sala de recuperación posanestesica. Estudio de investigación clínica, estadístico-prospectivo, doble ciego, 150 pacientes, 75 del grupo K, Ketamina 0,8 mg /kg EV mas Tiopental sódico 2 mg/kg EV y 75 del grupo T, Tiopental sódico 5 mg/kg EV, en ambos grupos se administró Anestesia General Balanceada, se valoró calidad de analgesia posoperatoria mediante, el tiempo de analgesia, escala visual numérica para intensidad del dolor y dosis de Morfina suplementaria como dosis rescate en el posoperatorio. Ambos grupos poblacionales fueron similares, con parámetros hemodinámicos y efectos adversos sin diferencia estadísticamente significativa. El tiempo analgésico, definido como el tiempo transcurrido hasta la necesidad de la primera dosis analgésica posoperatoria fue mayor en el grupo K comparado con el grupo T (media 194,64 min. EE 12,00 vs 143,54 EE 7,52 p 0,0001). Escala visual numérica = 3 se presento en el grupo K con diferencia significativa (p 0,0092) y el promedio del consumo total de morfina también fue menor en el grupo K 3.12 mg (EE 0.59) y en el grupo T 6.15mg (E 0.67) obteniéndose p: 0.00001. En este trabajo de investigación la Ketamina demostró marcado efecto en la analgesiaposoperatoria de la población estudiada, no solo por su efecto antagónico de los receptores N.M.D.A, receptores involucrada en la transmisión del dolor sino también por su interacción con receptores opioides, lo cual es concordante con la bibliografía consultada. Su metabolito Norketamina potencia el efecto opioide y potencia el efecto ntinociceptivo de la Morfina

SUMMARY: The association aims to enhance drugs beneficial effects and reduce adverse reactions, this research seeks to demonstrate the effects of the association of sodium thiopental with ketamine subtherapeutic, compared with sodium thiopental for induction of general anesthesia for elective and emergency cholecystectomies , focusing on the effect on postoperative analgesia in recovery room postanesthesic. Clinical research study, statistical-prospective, double blind, 150 patients, 75 of Group K, ketamine 0.8 mg / kg sodium thiopental EV 2 mg / kg group and 75 EV T thiopental sodium 5 mg / kg IV, in both groups were given general anesthesia, was assessed by postoperative quality of analgesia, analgesia duration, visual numeric scale for pain intensity and supplemental morphine as rescue doses postoperatively. Both populations were similar, with adverse hemodynamic and no statistically significant difference. The analgesic time, defined as time to first need for postoperative analgesic dose was higher in group K than in group T (mean 194.64 min. 12.00 vs 143.54 EE EE 7.52 p 0, 0001). Visual numeric scale = 3 is presented in the K group with significant difference (p 0.0092) and mean total morphine consumption was also lower in group K 3.12 mg (SD 0.59) and in group T 6.15mg (E 0.67) to obtain p: 0.00001. In this research work, ketamine showed marked effect in postoperative analgesia of the population studied, not only by its antagonistic effect of NMDA receptors, receptors involved in pain transmission but also by their interaction with opioid receptors, which is consistent with the literature. Norketamine metabolite enhances the effect and power opioip antinociceptive effect of morphine

Cardioprotection Via Modulation of Calcium Homeostasis by Thiopental in Hypoxia-Reoxygenated Neonatal Rat Cardiomyocytes

PURPOSE: Ca2+ homeostasis plays an important role in myocardial cell injury induced by hypoxia-reoxygenation, and prevention of intracellular Ca2+ overload is key to cardioprotection. Even though thiopental is a frequently used anesthetic agent, little is known about its cardioprotective effects, particulary in association with Ca2+ homeostasis. We investigated whether thiopental protects cardiomyocytes against hypoxia-reoxygenation injury by regulating Ca2+ homeostasis. MATERIALS AND METHODS: Neonatal rat cardiomyocytes were isolated. Cardiomyocytes were exposed to different concentrations of thiopental and immediately replaced in the hypoxic chamber to maintain hypoxia. After 1 hour of exposure, a culture dish was transferred to the CO2 incubator and cells were incubated at 37degrees C for 5 hours. At the end of the experiments, the authors assessed cell protection using immunoblot analysis and caspase activity. The mRNA of genes involved in Ca2+ homeostasis, mitochondrial membrane potential, and cellular Ca2+ levels were examined. RESULTS: In thiopental-treated cardiomyocytes, there was a decrease in expression of the proapoptotic protein Bax, caspase-3 activation, and intracellular Ca2+ content. In addition, both enhancement of anti-apoptotic protein Bcl-2 and activation of Erk concerned with survival were shown. Furthermore, thiopental attenuated alterations of genes involving Ca2+ regulation and significantly modulated abnormal changes of NCX and SERCA2a genes in hypoxia-reoxygenated neonatal cardiomyocytes. Thiopental suppressed disruption of mitochondrial membrane potential (Delta Psi m) induced by hypoxia-reoxygenation. CONCLUSION: Thiopental is likely to modulate expression of genes that regulate Ca2+ homeostasis, which reduces apoptotic cell death and results in cardioprotection.

Propofol vs. thiopental NA; pregnancy outcome and postoperative nausea and vomiting [PONV] in art cycle

The aim of this study was to compare the side effects, fertilization rate and pregnancy rate [PR] and duration of recovery between Propofol and Thiopental Na after ICSI-vaginal retrieval of oocyte in ART cycle. This study was a prospective, randomized clinical trial. Ninety eight ASA [American Society of Anesthesiologist] physical status I and II women participating in an intracytoplasmic sperm injection [ICSI] program were assessed. All of the patients underwent general anesthesia induction with Propofol and Thiopental Na. The first group [49 cycles] received 2-2.5mg/kg of Propofol, and the second group [49 cycles] received 5mg/kg Thiopental during transvaginal oocyte retrieval. An informed consent form was obtained for each patient's treatment. Variables under study included: female age, cause and duration of infertility postoperative nausea and vomiting [PONV], heamodynamic changes, mean number of oocyte retrieved, oocyte metaphase II, embryo cleaved, embryo transferred, embryo quality and pregnancy rate [PR] and duration recovery. Statistical analysis was carried out by using SPSS. 10 software and statistical test of T-test and chi-square. The PR in Propofol group was 18 [36.7%] and in Thiopental Na group was 19 [38.8%] with no significant differences the mean duration of infertility and weight weren't statistically significant. The mean number of oocyte retrieved [metaphase II], embryo cleaved, embryo transferred and embryo quality weren't significant between the two groups. The incidence of nausea in Propofol group in comparison with Thiopental Na group was lower with significant differences. The incidence of vomiting between two groups was statistically significant [46.9% vs. 28.6% respectively] [p<0.05] between two groups Duration of recovery in Propofol group was 15 +/- 3 min and in Thiopental Na group was 25 +/- 5 min that was statistically significant [P<0.05]. Propofol offered lowerincidence of post operative nausea and vomiting and a quick recovery from anesthesia without any adverse effect on pregnancy outcome. These findings showed that Propofol was a good alternative for Thiopental Na in short time operation, like ICSI -vaginal retrieval of oocytes

Neuroprotective effect of ketamine/xylazine on two rat models of Parkinson's disease

There is a great concern in the literature for the development of neuroprotectant drugs to treat Parkinson's disease. Since anesthetic drugs have hyperpolarizing properties, they can possibly act as neuroprotectants. In the present study, we have investigated the neuroprotective effect of a mixture of ketamine (85 mg/kg) and xylazine (3 mg/kg) (K/X) on the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) or 6-hydroxydopamine (6-OHDA) rat models of Parkinson's disease. The bilateral infusion of MPTP (100 æg/side) or 6-OHDA (10 æg/side) into the substantia nigra pars compacta of adult male Wistar rats under thiopental anesthesia caused a modest (~67 percent) or severe (~91 percent) loss of tyrosine hydroxylase-immunostained cells, respectively. On the other hand, an apparent neuroprotective effect was observed when the rats were anesthetized with K/X, infused 5 min before surgery. This treatment caused loss of only 33 percent of the nigral tyrosine hydroxylase-immunostained cells due to the MPTP infusion and 51 percent due to the 6-OHDA infusion. This neuroprotective effect of K/X was also suggested by a less severe reduction of striatal dopamine levels in animals treated with these neurotoxins. In the working memory version of the Morris water maze task, both MPTP- and 6-OHDA-lesioned animals spent nearly 10 s longer to find the hidden platform in the groups where the neurotoxins were infused under thiopental anesthesia, compared to control animals. This amnestic effect was not observed in rats infused with the neurotoxins under K/X anesthesia. These results suggest that drugs with a pharmacological profile similar to that of K/X may be useful to delay the progression of Parkinson's disease.

[Comparative efficacy of combination of propofol or thiopental with remifentanil on tracheal intubation without muscle relaxants]

In some medical situations administration of muscle relaxants after intravenous anesthetics for tracheal intubation may be unnecessary or sometimes could be hazardous. In such situations, replacing an alternative drug for the facilitation of tracheal intubation is obvious. Remifentanil is a short acting opioid drug which may be useful in solving this problem. The aim of this study was to compare the effects of propofol or thiopental in combination with remifentanil in the absence of muscle relaxants on larengoscopy and intubation conditions in general anesthesia. This is a randomized double-blind clinical trial which was performed in 1386 in Be'sat hospital of Sanandaj. Forty two ASA 1 and 2 patients recruited to receive propofol, 2 Mg/Kg, or thiopental, 5Mg/K. All patients received lidocaine, 1.5Mg/Kg, and remifentanil, 2.5 micro g/Kg, 30 seconds before anesthetics administration. Iarenoscopy and tracheal intubation were done 90 seconds after induction of anesthesia. On the basis of mask ventilation, jaw relaxation, vocal cords position and patient's response to intubations and endotracheal tube cuff inflation the intubation conditions were assessed and recorded as excellent, good, acceptable or poor. The mean arterial pressure and heart rate were measured before and after anesthetics administration and also 45 seconds and two and five minutes after intubations. Data were analyzed by X[2], fisher exact test and student T-test using SPSS software. Excellent or good larengoscopy and intubation conditions were observed in 9 [%42.9] of thiopental patients and 20 [%95.2] of propofol patients [p<0.05]. Mean arterial pressure and heart rate decreased more significantly in propofol group in comparison with the thiopental group [p<0.05]. Combination of remifentanil and propofol or thiopental could facilitate ventilation via face mask in all patients. Although combination of propofol and remifentanil is better than thiopental and remifentanil for tracheal intubation without muscle relaxants, it induces more homodynamic changes

Monitor Alaris A-Line Arx Index (AAI): utilidad en la determinación de las dosis inductoras de propofol y tiopental para anestesia general y su relación con la inhalación de óxido nitroso / Alaris A-Line Arx Index (AAI) Monitoring: usefulness to determine the induction doses of propofol and thiopental for general anesthesia and its relationship with nitrous oxide inhalation

Introducción: El índice A-Line (AAI) permite monitorizar la profundidad anestésica. Objetivo: Determinar las dosis inductoras (DI) de propofol (P) y tiopental (T) mediante AAI. Evaluar la influencia del óxido nitroso 50 por ciento sobre las DI. Pacientes y método: Estudio prospectivo, controlado, en 120 pacientes ASA I-II, con IMC < 30, divididos en cuatro grupos: grupo P1 (n=30): O2 100 por ciento; Grupo P2 (n=30): N2O/O2 50 por ciento, Grupo T1 (n=30): O2 100 por ciento; Grupo T2 (n=30): N2O/O2 50 por ciento. Se instaló equipo de AAI. Se administró propofol (1 por ciento) o tiopental (2,5 por ciento) a 120 ml/h hasta obtener un AAI < 40 (hipnosis clínica) y AAI < 20 (nivel quirúrgico). Se registraron los signos vitales y las DI para AAI de 40 y 20. Resultados: Las DI de P: Grupo P1, 132,3 mg (AAI 40) y 185,6 mg (AAI 20), correspondientes a 1,91 ± 0,67 mg/kg y 2,78 ± 0,72 mg/kg. En el Grupo P2 las DI fueron de 94,7 mg (AAI 40) y 122,4 mg (AAI 20), correspondientes a 1,23 ± 0,3 mg/kg y 1,69 ± 0,47 mg/kg (p< 0,01, P2 v/s P1). Las DI de tiopental: Grupo T1 fue 349,5 mg (AAI 40) y 504,3 mg (AAI 20), correspondientes a 5,62 ± 0,9 mg /kg y 7,96 ± 1,2 mg/kg. En el Grupo T2, las DI fueron 311,2 mg (AAI 40) y 414,3 mg (AAI 20), correspondientes a 4,01 ± 0,7 mg/kg y 5,21 ± 0,9 mg/kg (p < 0,01 T2 v/s T1). Conclusiones: La utilización de AAI permite determinar adecuadamente las DI de P y T. La inhalación de N2O 50 por ciento reduce las DI de P y T.

Apgar score of neonate; comparison of thiopentone and propofol during c-section

A comparative study was conducted in CMH, Malir, CMH, Kharian and WT [Pvt] Ltd. Gynaecology and Obstetrics, Multan from April 2001 to March 2004. The Apgar score of neonate was compared for thiopentone or propofol in C-section patients. Two groups of patients were made. Group-A was induced with thiopentone and group-B was induced with propofol. Each group had 100 patients. In group-A 13 neonates required manipulation and 2 neonates in group-B also required manipulation like mask ventilation or endotracheal intubation and one of drugs like atropine to improve apgar score. 13% neonates in group-A and 1% neonates in group-B required manipulation. This clearly shows the superiority of propofol over thiopentone as an induction agent in C-section. The P value of group-A was 0.13 and for group B was 0.02 and had had a statistically significant difference

Effect of thiopental sodium on the release of glutamate and gamma-aminobutyric acid from rats prefrontal cortical synaptosomes / 华中科技大学学报（医学）（英德文版）

To investigate the effect of thiopental sodium on the release of glutamate and gamma-aminobutyric acid (GABA) from synaptosomes in the prefrontal cortex, synaptosomes were made, the spontaneous release and the evoked release by 30 mmol/L KCl or 20 micromol/L veratridine of glutamate and GABA were performed under various concentrations of thiopental sodium (10-300 micromol/L), glutamate and GABA concentrations were determined by reversed-phase high-performance liquid chromatography. Our results showed that spontaneous release and evoked release of glutamate were significantly inhibited by 30 micromol/L, 100 micromol/L and 300 micromol/L thiopental sodium, IC50 of thiopental sodium was 25.8 +/- 2.3 micromol/L for the spontaneous release, 23.4 +/- 2.4 micromol/L for KCl-evoked release, and 24.3 +/- 1.8 micromol/L for veratridine-evoked release. But GABA spontaneous release and evoked release were unaffected. The study showed that thiopental sodium with clinically related concentrations could inhibit the release of glutamate, but had no effect on the release of GABA from rats prefrontal cortical synaptosomes.

dilemma of hemodynamic instablitiy during induction of anethesia: can midazolam serve as a suitable substitute for thiopentone?

Both midazolam and thiopental sodium are being used as induction agents and for maintenance of anesthesia. In contrast to other benzodiazepines such as diazepam, metazoan has a rapid onset of action and fast distribution and causes few cardiovascular or respiratory effects. Being water soluble, midazolam is also associated with a low incidence of venous irritation. The purpose of this study was to see whether midazolam is a suitable substitute for thiopental sodium as an induction agent. To compare the hemodynamic changes associated with midazolam and thiopental sodium as induction agents, this study was conducted in two groups each comprising of 30 patients. No significant hemodynamic changes regarding heart rate and blood pressure could be noticed in the two groups [p<0.05]. All patients in the midazolam group exhibited anterograde amnesia but in the thiopental group, 20% of the patients had recall for operative events one hour after completion of surgery. To arrive at more conclusive results, preferably multi-center studies involving large numbers of cases are recommended

Midazolam and thiopentone co-induction: looking for improvement in quality of anaesthesia

To evaluate improvement in quality of anaesthesia induction using thiopentone and midazolam for co-induction of anaesthesia. An additional end point was taken as loss of response to a tetanic stimulation [50 Hz] delivered for 5 seconds after the loss of verbal contact and eyelash reflex. Ninety ASA I and II patients, within the age range of 20-60 years were studied. Patients were randomly divided into three equal groups; A, B and group C Onset of induction and loss of response to a tetanic stimulation was achieved earlier in group B as compared to the other study groups [p<0.05]. Co-induction with midazolam 0.02 mg.kg-1 followed by thiopentone 3 mg.kg-1 was superior to other two groups. Induction of anaesthesia in this group was found to be smoother and faster, provided better hemodynamic stability, better airway maintenance and with lesser incidence of untoward effects

Post-operative nausea and vomiting in out-patient gynecologic laparoscopy: a comparison of thiopental-nitrous oxide, propofol-nitrous oxide and total intravenous anesthesia using propofol.

An intravenous anesthetic drug, propofol was considered to pose antiemetic action. A randomized controlled trial was conducted to evaluate whether propofol could effectively reduce post-operative nausea and vomiting (PONV) compared to thiopental-nitrous oxide (N2O). One-hundred and eight patients undergoing outpatient gynecologic laparoscopy were assigned to receive 3 techniques of anesthesia; thiopental-N2O (T/N), propofol-N2O (P/N) and total intravenous anesthesia (TIVA) using propofol (P/P). The results showed that in the early period (0-5 hours), post-operative nausea in T/N, P/N and P/P groups was 72 per cent, 44 per cent and 31 per cent, respectively (P = 0.002), and post-operative vomiting was 58 per cent, 36 per cent and 11 per cent respectively (P = 0.00014). Patients in the P/N and P/P groups experienced nausea less frequently than the T/N group [relative risk (RR) = 0.62, (95% CI 0.41-0.93) and RR = 0.42 (0.25-0.72) respectively]. Patients in the P/N and P/P groups experienced vomiting less frequently than the T/N group [RR = 0.62 (0.37-1.04) and RR = 0.19 (0.07-0.5) respectively]. Two patients in the T/N group were admitted because of severe nausea and vomiting. In conclusion, TIVA using propofol and propofol-N2O anesthesia can significantly reduce the incidence of PONV in the early period. Concerning the economic crisis of the country as well as the quality of care, propofol-N2O would be the most appropriate anesthetic of choice.

Analgesic effects of propofol on orthopedics' day surgeries.

The present study was designed to assess analgesic effects of propofol on orthopedics' day surgeries. 150 adult patients undergoing orthopedics' day surgeries were randomly divided into 3 groups and allocated to receive either propofol, ketamine or thiopenal for induction and maintaining anesthesia, after premedication by 1 [micro] g/kg of fentanyl. To evaluate pain and to detect painful stimulation, parameters such as heart rate, systolic and diastolic arterial blood pressure, respiratory rate, pupil size, perspiration, muscle movement, awareness in recovery room, recall during surgery and satisfaction from anesthesia were used. Changes in these parameters were significantly greater in propofol group. We concluded that propofol does not have analgesic effects during anesthesia and must be accompanied by an analgesic like fentanyl or alfentanil and can be used by intravenous bolus method

Cambios de la presión intraocular durante la inducción anestésica e intubación endotraqueal con propofol - tiopental: estudio comparativo / Changes of the intraocular pressure during the anesthetic induction and endotraqueal intubación with propofol-tiopental: comparative study

El buen control de la Presión Intraocular (PIO), especialmente durante la inducción anestésica e intubación endotraqueal, constituye una característica deseable para cirugía oftálmica, este control tiene especial importancia para casos de heridas de ojo, glaucoma, intervenciones intraoculares y en todos los casos en que un aumento de la PIO, puede causar protrución del contenido intraocular con irreparables pérdidas para el paciente como es la pérdida de la visión. La ausencia de reacciones de faringe y laringe en la misma intubación endotraqueal, harán que la PIO, no se eleve en las intervenciones oftalmológicas. Para la presente investigación descriptiva - comparativa se seleccionó una muestra de 40 pacientes que requirieron de cirugía oftálmica, los mismos que cumplieron los siguientes criterios de inclusión: Pacientes que habían sido aceptados aptos para cirugía, ASA I y II de cualquier sexo y edad. El 50 por ciento de los pacientes recibió inducción con PROPOFOL, (2,5 mg/kg de peso) para menores de 55 años, y de (2 mg./kg de peso) o menos en mayores de 56 años; y el 50 por ciento restante, recibió TIOPENTAL, (3 a 5 mg/kg) con el propósito de evaluar cual de los dos fármacos produce una disminución más significativa de la PIO, para establecer éste objetivo se usó el Tonómetro de Schiotz, previa aplicación de dos gotas de tetracaina oftálmica en el ojo a ser intervenido quirúrgicamente. Como relajante muscular se utilizó Bromuro de Pancuronio, a la dosis de (0,06 - 0,08 mg/kg) en los dos grupos de pacientes. Como pudimos apreciar en nuestro estudio, los pacientes que recibieron Propofol presentaron en la pre-inducción una presión intraocular media en el ojo izquierdo de (16,5mmHg) con una desviación estándar de (25mmHg) y en la post-inducción (12,00mmHg) con una desviación estándar de (4,51mmHg) lo que nos da una diferencia estadística (p= 0,004) altamente significativa, igualmente en el ojo derecho obtuvimos una presión intraocular media de (16,4mmHg) con una desviación estándar de (4,73mmHg) en la pre-inducción y en la post-inducción (10,85 mmHg) con una desviación estándar de (3,62mmHg) dándonos una diferencia estadística (p= 0,0002) altamente significativa; no así los que recibieron...

Efeitos analgésico e hipnótico das associaçöes do sufentanil com tiopental e com o propofol, em ratos / Analgesic and hypnotic effects of sufentanil with thiopental and sufentanil with propofol, in rats

O objetivo deste estudo foi avaliar a açao analgésica do sufentanil com a açao hipnótica do tiopental e do propofol, os quais foram ministrados por via intraperitoneal, em 60 ratos Wistar. Os animais foram distribuídos em dois grupos de 30 e submetidos a diferentes doses de sufentanil, tiopental e propofol para determinaçao das doses, analgésica e hipnóticas, médias. A dose do sufentanil foi determinada com estímulos padronizados pelo pinçamento da cauda do animal. Enquanto que com o tiopental e o propofol objetivou-se a dose hipnótica média, onde a resposta foi a perda de postura. Da interaçao do tiopental com o sufentanil obteve-se uma açao hipnótica aumentada e prolongada. Enquanto, o propofol associado ao sufentanil mostrou um início mais lento, porém com maior duraçao da açao hipnótica. Com relaçao à açao analgésica da associaçao do tiopental e sufentanil, obteve-se um aumento significante. Enquanto, na associaçao do propofol com sufentanil nao se detectou diferença significante. A associaçao do tiopental com sufentanil apresentou maior potência hipnótica e analgésica quando comparada à associaçao do propofol com sufentanil. Da mesma forma, quando se observou a presença concomitante de hipnose e analgesia, a associaçao do tiopental com sufentanil apresentou uma açao mais longa do que o propofol com sufentanil.

Influência do tiopental e do propofol nas condiçöes de intubaçäo traqueal com rocurônio / Influence of propofol and thiopental on the intubating conditions after rocuronium

Justificativa e objetivos: o rocurônio é um bloqueador neuromuscular adespolarizante que apresenta rápido início de açäo. Experimentalmente foi observado que o agente de induçäo pode interfirir na instalaçäo do relaxamento muscular. O objetivo deste estudo foi comparar a qualidade das condiçöes de intubaçäo traqueal com o rocurônio, após a administraçäo de propofol ou tiopental. Método: participaram do estudo trinta pacientes de ambos os sexos, estado físico (ASA) I e II, submetidos a cirurgias eletivas. Todos os pacientes receberam midazolam 5 a 15mg por via oral como medicaçäo pré-anestésica, noventa minutos antes da induçäo da anestesia. Após a monitorizaçäo, que constou de eletrocardiografia em DII, aferiçäo automática da pressäo arterial e oximetria de pulso, todos os pacientes receberam oxigênio a 100 por cento sob máscara e fentanil 2-5µg.kg(elevado a menos um) por via venosa. Os pacientes foram entäo distribuídos aleatoriamente em dois grupos, que receberam propofol (n=15) ou tiopental (n=15) em doses suficientes para abolir o reflexo palpebral. O bloqueio neuromuscular foi obtido com a administraçäo de rocurônio na dose de 0,6mg.kg(elevado a menos um). As condiçöes de intubaçäo traqueal foram analisadas aos 60 segundos após a administraçäo do rocurônio e pontuadas por escala de avaliaçäo clínica. Os dados estatísticos foram avaliados pelos testes t de Student, x² e teste de Mann Whitney. Resultados: o grupos foram homogêneos quanto ao sexo, idade, peso e altura. As condiçöes de intubaçäo traqueal foram similares nos dois grupos e foram classificadas como excelentes ou boas em quase todos os casos. Conclusöes: conclui-se que ambos agentes, propofol e tiopental, promoveram condiçöes similares de intubaçäo traqueal aos 60 segundos após a injeçäo de rocurônio na dose de 0,6mg.kg(elevado a menos um)