Thiopental Sodium
Trade names: Pentothal
Class: Barbiturates " Intravenous anesthetic "
Pregnancy:
(Category C) Action:
Thiopentone is a very short acting I.V
Barbiturate used as an anesthetic agent. It has poor analgesic and muscle
relaxing properties.
Uses:
v as the sole anesthetic agent for brief (15 minute) procedures,
v for induction of anesthesia prior to administration of other
anesthetic agents,
v to supplement regional anesthesia,
v to provide hypnosis during balanced anesthesia with other agents
for analgesia or muscle relaxation,
v for the control of convulsive states during or following
inhalation anesthesia, local anesthesia, or other causes,
v in neurosurgical patients with increased intracranial pressure,
if adequate ventilation is provided, and
v for narcoanalysis and narcosynthesis in psychiatric disorders.
Dose:
induction of general anaesthesia, by
intravenous injection as a 2.5% (25 mg/mL) solution, induction 3-5 mg/kg , in
fit premedicated adults, initially 100–150 mg (reduced in elderly or
debilitated) over 10–15 seconds (longer in elderly or debilitated), followed by
further quantity if necessary according to response after 30–60 seconds; or up
to 4 mg/kg; CHILD induction
2–7 mg/kg
Raised intracranial
pressure, by intravenous injection, 1.5–3 mg/kg/hour Contraindications:
Absence
of suitable veins for intravenous administration, hypersensitivity (allergy) to
barbiturates and variegate porphyria (South African) or acute intermittent
porphyria.
Side effects:
§
Adverse reactions include
§
respiratory depression,
§
myocardial depression,
§
cardiac arrhythmias,
§
prolonged somnolence and
recovery,
§
sneezing,
§
coughing,
§
bronchospasm,
§
laryngospasm and shivering.
§
Anaphylactic and
anaphylactoid reactions to Pentothal (Thiopental Sodium for Injection, USP)
have been reported. Symptoms, e.g., urticaria, bronchospasm, vasodilatation and
edema should be managed by conventional means.
Nursing
considerations:
§ Barbiturate anesthetics should be administered only by
individuals familiar with their use and skilled in airway management. Age- and
size-appropriate resuscitative and endotracheal intubation equipment, oxygen,
and medications for prevention and treatment of anesthetic emergencies must be
immediately available. Airway patency must be maintained at all times
§ Care should be taken to avoid extravasation or intra-arterial
injection of barbiturate anesthetics.
§
Extravascular injection may
cause pain, swelling, ulceration, and necrosis. Intraarterial injection may
produce arteritis, followed by vasospasm, edema, thrombosis, and gangrene of an
extremity.
§
Sterile water for
injection, 5% dextrose injection, or 0.9% sodium chloride injection may be used
as diluents. Bacteriostatic diluents and lactated Ringer's injection
should not be used as diluents because they tend to cause
precipitation
