Althesin in the Management of Head Injuries

Abstract

The aggressive treatment of major craniocerebral trauma has received recent attention. Barbiturate administration has been beneficial in some cases of sustained, uncontrolled intracranial hypertension. One major disadvantage of pentobarbital narcosis is the long half-life of the drug (15 to 48 hours). We have used Althesin, an intravenous steroid anesthetic (alfaxalone and alfadolone acetate; Glaxo Laboratories Ltd., Greenford, Middlesex, England), in eight seriously head-injured patients. Althesin combines the theoretical advantages of pentobarbital in the management of head trauma with almost immediate reversibility (serum half-life, 1.6 minutes). Raised intracranial pressure and clinical outcome seem to be influenced favorably and the side effects are negligible when the drug is administered by continuous intravenous infusion over several days. Further study of this compound in the management of head trauma seems warranted.

Comparison of Etomidate and Althesin in the Reduction of Increased Intracranial Pressure After Head Injury

“…Since the study was completed, the manufacture of Althesin has been discontinued because of concern about anaphylactoid reactions. None-the-less, withdrawal is so recent that the drug provides a useful and familiar yardstick of comparison in respect of controlling ICP following head injury (Mcllhany et al, 1983;Moss et al, 1983). Certainly, an hypnotic drug to control ICP is needed-other than the barbiturates, which are associated with circulatory depression and delayed excretion (Krier et al, 1984;Miller et al, 1984).…”