A Pilot Study of Cerebral and Hemodynamic Changes During Sedation with Low Dose of Thiopental Sodium or Propofol in Patients with Acute Brain Injury

Yaghoobi, Siamak; Khezri, Marzieh Beigom; Alamouti, Azam Mohammadi

doi:10.7860/jcdr/2015/13955.6383

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…In this respect, whether the reduction in cerebral blood flow due to thiopental is a consequence of the reduced metabolic demand of the neuronal tissue is unclear 16 . However, a previous study suggested that thiopental is a potent cerebral vasoconstrictor that decreases ICP by reducing cerebral blood flow 17 . Thiopental has a more pronounced effect on cerebral microvascular vasoconstriction than propofol 18,19 .…”

Section: Discussionmentioning

confidence: 96%

Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens

et al. 2022

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To determine the normal optical nerve sheath (ONS) diameter ultrasonography (ONSUS) and evaluate the possible effects of drugs on ONS diameter during anesthetic induction in healthy pigs. Methods: Healthy piglets were divided into three groups: a control group, that received xylazine and ketamine (X/K); other that received xylazine, ketamine and propofol (X/K/P); and a third group that received xylazine, ketamine, and thiopental (X/K/T). The sheath diameter was assessed by ultrasonography calculating the average of three measurements of each eye from the left and right sides. Results: 118 animals were anesthetized (49 X/K 33 X/K/P and 39 X/K/T). Mean ONS sizes on both sides in each group were 0.394 ± 0.048 (X/K), 0.407 ± 0.029 (X/K/P) and 0.378 ± 0.042 cm (X/K/T) (medians of 0.400, 0.405 and 0.389, respectively). The ONS diameter varied from 0.287-0.512 cm (mean of 0.302 ± 0.039 cm). For group X/K, the mean diameter was 0.394 ± 0.048 cm. Significant differences in ONS sizes between the groups P and T (X/K/P > X/K/T, p = 0.003) were found. No statistically significant differences were detected when other groups were compared (X/K = X/K/P, p = 0.302; X/K = X/K/T, p = 0.294). Conclusion: Sedation with thiopental lead to significative ONS diameter reduction in comparison with propofol. ONSUS may be useful to evaluate responses to thiopental administration.

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Section: Discussionmentioning

confidence: 96%

Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens

et al. 2022

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“…29 Finally, a single study evaluated low-dose thiopental against propofol. 30 Due to the scarcity of data (patient characteristics, methods of measuring variables, protocol details, co-interventions), an unexplained age inclusion criterion (15-45 years), and grammatical and syntactic deficiencies that impaired understanding, its results were deemed as unreliable.…”

Section: Intravenous Sedative Agentsmentioning

confidence: 99%

Sedation During Neurocritical Care

Vanaclocha

Chisbert

Quilis

et al. 2019

Journal of Neuroanaesthesiology and Critical Care

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Sedation is an essential therapeutic strategy in the care of neurocritical patients. Intravenous sedative agents are the most widely used, with promising alternatives (dexmedetomidine, ketamine, and volatile agents) to propofol and midazolam arising. Studies designed to evaluate superiority and avoid biases are required. A neurological awakening test is safe in most patients. Potential risks and benefits of limiting deep sedation and daily interruption of sedation in these patients remain unclear. The aim of this review was to report recent clinical evidence on sedation in this subgroup of patients, focusing on its effects on clinical prognosis.

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“…Thiopental sodium is a barbiturate commonly used in induction since 1934. Since intracranial pressure (ICP) increases due to cerebral hemorrhage and edema in head trauma, barbiturates, which lead to a decrease in cerebral blood flow (CBF) and ICP by cerebral vasoconstriction, may be preferred (6,36). However, it has been reported that induction with thiopental sodium increases critical respiratory problems approximately 2-fold in the postoperative period.…”

Section: General Anesthesiamentioning

confidence: 99%

Approach to Patients with Neurotrauma and Thoracic Trauma and Anesthesia Management with Current Guidelines II

Mingir¹,

Berktaş²,

Türkmen³

et al. 2019

eamr

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Anesthesia Management in Trauma Trauma, which means wound in ancient Greek, is the leading cause of death in the 1-44 age group, and the third cause of death following cancer and cardiovascular disease in all age groups. Trauma is defined as tissue damage characterized by structural changes and physiological disorders due to mechanical, thermal, electrical and chemical energies, ionized or nuclear radiation or absence of essential elements of life such as oxygen and heat. Trauma has many reasons such as traffic accidents, work accidents and falling from height (1,2). These patients need a systematic anesthesia management in posttraumatic evaluation, airway management, resuscitation, possible preoperative and postoperative surgical process, intensive care follow-up and treatment (3). The nature of trauma, uncontrollable bleeding after trauma, coagulation anomalies, hypothermia, shock, acidosis disrupt the normal homeostatic mechanism. Acute coagulopathy caused by high blood loss in major traumas is often associated with poor clinical course in trauma patients (4,5). Another paradox is the nature of unexplained events, insufficient anamnesis information and the necessity of emergency intervention in trauma cases. Initial Assessment of Trauma Algorithms have been defined for systemic approach to trauma patients and more than fifty scoring systems have been developed. The Trauma score, which was defined in 1981 by adding respiratory rate and systolic blood pressure to the Triage index, is a widely used scoring system. It was revised in 1989 and Revised Trauma score was formed (Table 1). In order for the trauma centers to systematically engage a modern trauma approach in harmony between the other disciplines, it is necessary to establish national guidelines tailored to the needs and ensure their widespread use. Airway obstruction, severe hemorrhage and hypoxia due to tension pneumothorax may be among the causes of early death due to trauma (6-8). From the moment the trauma patient is met, the first step is to apply the

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A Pilot Study of Cerebral and Hemodynamic Changes During Sedation with Low Dose of Thiopental Sodium or Propofol in Patients with Acute Brain Injury

Cited by 4 publications

References 15 publications

Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens

Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens

Sedation During Neurocritical Care

Approach to Patients with Neurotrauma and Thoracic Trauma and Anesthesia Management with Current Guidelines II

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