A Comparative Clinical and Statistical Study of Thiopental and Thiamylal in Human Anesthesia

Tovell, Ralph M.; Anderson, C.; Sadove, Max S.; Artusio, Joseph F.; Papper, E. M.; Coakley, Charles S.; Hudon, F; Smith, Scott M.; Thomas, George J.

doi:10.1097/00000542-195511000-00009

Cited by 12 publications

(3 citation statements)

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“…However, it is the consensus of many investigators that all tl-uobarbiturates owe their spparent rap~d actaon to a redistnbntmn of the drug from the plasma to fat, and that the search for better intravenous anaesthetm agents should be directed towards co~npounds other than the thiobarblturates (11). SUMMAMY 1 The use of Neraval has been studied during the course of 800 clinical admlmstrattons 2.…”

Section: Discussionmentioning

confidence: 99%

The clinical usage of neraval

O’Herlihy¹,

Nishimura²,

Little³

et al. 1956

Can Anaes Soc J

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be produced and tested clinically as anaesthetic agents (1). Today, a short twelve months later, that prophecy already is becoming fact, and a number of these agents have appeared upon the anaestheslologist's ]horizon. Among these, there are at least two new ultra-short-acting intravenous barbltttrates that, on the basis of available data from laboratory experimentation, warrant further clinical trial and study.There is a certain ]ustificatign for the continning search an-ned towards the introduction of a more desirable intravenous anaesthetic agent. The drugs of this type which are presently avadable have been eminently successful in revolutionizing anaesthetic practices wathm the past two decade,;, they have effectively abolished the fear of anaesthesia, and they have made the prolonged, stormy inductions of an earlier day a thing of the past. They have not, however, proved to be ideal drugs on a number of counts These barbiturates often have acted as selective depressants of the medullary centres, parhcularly the centres i controlling respiratory activity and vasomotor tone Respiratory depression and hypotension occasionally have been alarming m degree following admin,stration of these drugs. Furthermore, parasympathomimehc effects have been exhibited which have resulted in such induction complications as coughing, sneezing, laryngospasm, and hiccups; these phenomena, whtle usually merely annoying, have on other occasions been truly dangerous. Finally, and of most importance, the ultrashort-acting barbiturates have been shown to be, art fact~ rather slowly metabolized (2) (3) (4) (5) (6). Convincing evidence has been amassed to demonstrate that the apparently short durahon of thaobarb~turate anaesthesia is dependent upon a relatively rapid redist-nbutlon of plasma levei[s of the drug mto the fat depots, from which it is slowly liberated and metabohzed. Mimmal doses thus are of short durahon, but larger doses produce prolonged hypnosis. This drawback has intens,fied the search for a tlnobarblturate that is metabolized more rapidly m the body and will thus permit better control ot: the anaesthetic state: Nerava] Sochum has been suggested as just such a drug. CHEMISTRY AND PHARM4COLOCYNeraval Sodium I is the sodium salt of methyl-thio-ethyl-2}-pentyl-thiobarbituric acid.

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Section: Discussionmentioning

confidence: 99%

The clinical usage of neraval

O’Herlihy¹,

Nishimura²,

Little³

et al. 1956

Can Anaes Soc J

View full text Add to dashboard Cite

show abstract

“…New barbiturates have been described in the past year, namely, Surital or thioamylal (Dundee, 1955 ; Dundee and Riding, 1955 ; Mushin and others, 1955; Tovell and others, 1955) and Baytinal, a sulphur homologue of hexobarbitone, has been marketed in Germany (Weese and Koss, 1954). It is too early to say whether these new drugs can hope to displace the older agents ; for apart from minor variations in duration of action there is no evidence that they possess qualities which differ markedly from those of the established agents of this type.…”

Section: Intravenous Anaestheticsmentioning

confidence: 99%

“…a proportion of patients may prove resistant to It. Allowing blood loss to go untreated (McBurrows and others, 1956) or giving procaine amide may be used to augment the action of Arfonad (Anderson, 1955)• The latter of these measures should be discouraged, for procaine amide shares with procaine the power of producing cardiac arrest which has followed its use both in cardiological and anaesthetic practice (Weingarten and others, 1954). Liver damage has been regarded as a complication of the administra tion ofArfonad (Anlyan and others, 1954)' It must remain doubtful, however, whether the liver failure was a specific effect of the drug given or merely a consequence of dropping the blood pressure to levels at which portal circulation must inevitably fail (Narat and others,195'i).…”

Section: Hypotensionmentioning

confidence: 99%