Preliminary Experience With Ici 35 868 as an I.V. Induction Agent: Comparison With Althesin

Rogers, Karl; Dewar, K.M.S.; McCUBBIN, T.D.; Spence, A.

doi:10.1093/bja/52.8.807

Cited by 42 publications

(11 citation statements)

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“…did not affect the frequency of pain on injection, so it is probable that the reduced incidence in this study (12%) is related more to the site of injection than to the premedication with fentanyl. The fact that two patients out of 26 (8%) required a higher dose of disoprofol is in keeping with the findings of others (Rogers et al, 1980;Briggs et al, 1981;Major et al, 1981), who found that 2mgkg" 1 induced anaesthesia successfully in 90-100% of patients without unacceptable arterial hypotension or respiratory depression. They found l.Smgkg" 1 was unreliable and produced anaesthesia in only 25-70% of patients.…”

Section: Discussionsupporting

confidence: 88%

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Comparision of Ici 35868, Etomidate and Methohexitone for Day-Case Anaesthesia

Wells¹

1985

British Journal of Anaesthesia

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ICI 35868 is a substituted phenol (2-6, diisopropyl phenol) which has been shown to have anaesthetic properties. It is rapidly acting (7J approximately 55 min), and is completely metabolized, mainly by conjugation with glucuronic acid. There is minimal cumulation, more than 90 % of the dose being recovered in the urine (as metabolites) within 48 h.This study was designed to compare the efficacy and side-effects of di-isopropyl phenol, etomidate and methohexitone, when used for day-case anaesthesia. PATIENTS AND METHODSSeventy-one female patients in good general health (ASA class I), aged between 18 and 65 yr and scheduled for minor gynaecological procedures (dilatation and curettage or termination of pregnancy) were included in this open study. Written informed consent was obtained from each patient. Those with a history of allergy, atopy, previous known exposure to Cremophor and those taking drugs not specified in the trial, were excluded. Patients were allocated randomly to three groups to receive di-isopropyl phenol, etomidate or methohexitone. The number of patients undergoing dilatation and curettage or termination of pregnancy was balanced in each group. Anaesthetic techniqueAll patients received fentanyl 0.001 mg/kg body weight 2 min before the induction of anaesthesia.ICI 35868 was presented as a 1 % solution of di-isopropyl phenol in 16% Cremophor EL with water to 100% (disoprofol), and the other drugs were used in the commercially available preparations (etomidate, Janssen Pharmaceuticals; methohexitone, Eli Lilly & Co. Limited). SUMMARYInduction doses of disoprofol l.Smgkg" 1 (« = 26), etomidate 0.2 mgkg~l(« = 22) or methohexitone 1.5 mg kg~l {n = 23) were administered over 20 s (forearm or antecubital vein), and anaesthesia was maintained with 70% nitrous oxide in oxygen via a face mask, plus further increments of the appropriate induction agent. Incremental doses were 10-20% of the induction dose. At the end of surgery, 100% oxygen was administered for 2 min. Assessments of patientsThe following observations were made by one of two observers (the majority being made by the author): Induction time from the start of injection to the loss of eyelash reflex was measured in seconds; pain on injection was rated as present when reported spontaneously or in response to the question " Is your arm comfortable?" Respiratory abnormalities such as hiccup, sneeze, bronchospasm or apnoea of more than 30 s duration were noted. Heart rate, systolic and diastolic arterial pressures were recorded (Dinamap) at 1-min intervals. Recordings were started 2 min before the induction Downloaded from https://academic.oup.

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Section: Discussionsupporting

confidence: 88%

“…Previous studies (Kay and Roily, 1977;Rogers et al, 1980) have shown a high incidence of pain on injection (up to 50%) with disoprofol when small veins in the dorsum of the hand were used. Briggs and co-workers (1982) found that premedication with pethidine or papaveretum i.m.…”

Section: Discussionmentioning

confidence: 96%

Comparision of Ici 35868, Etomidate and Methohexitone for Day-Case Anaesthesia

Wells¹

1985

British Journal of Anaesthesia

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“…PRO has been used since the early 1980s (29) for the induction and maintenance of anesthesia in the operation room and sedation in the ICU. Metabolized in the liver, it is highly lipid soluble and has very short distribution and elimination half‐lives (2–4 min and 30–60 min, respectively) and little propensity to accumulate (13,21).…”

Section: Discussionmentioning

confidence: 99%

Propofol Treatment of Refractory Status Epilepticus: A Study of 31 Episodes

et al. 2004

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Summary:Purpose: Refractory status epilepticus (RSE) is a critical medical condition with high mortality. Although propofol (PRO) is considered an alternative treatment to barbiturates for the management of RSE, only limited data are available. The aim of this study was to assess PRO effectiveness in patients with RSE.Methods: We retrospectively considered all consecutive patients with RSE admitted to the medical intensive care unit (ICU) between 1997 and 2002 treated with PRO for induction of EEGmonitored burst suppression. Subjects with anoxic encephalopathy showing pathological N20 on somatosensory evoked potentials were excluded.Results: We studied 31 RSE episodes in 27 adults (16 men, 11 women; median age, 41.5 years). All patients received PRO, and six also subsequently thiopental (THP). Clonazepam (CZP) was administered with PRO, and other antiepileptic drugs (AEDs) concomitant with PRO and THP. RSE was successfully treated with PRO in 21 (67%) episodes and with THP after PRO in three (10%). Median PRO injection rate was 4.8 mg/kg/h (range, 2.1-13), median duration of PRO treatment was 3 days (range, 1-9), and median duration of ICU stay was 7 days (range, 2-42). In 24 episodes in which the patient survived, shivering after general anesthesia was seen in 10 episodes, transient dystonia and hyperlipemia in one each, and mild neuropsychological impairment in five. The seven deaths were not directly related to PRO use.Conclusions: PRO administered with CZP was effective in controlling most of RSE episodes, without major adverse effects. In this setting, PRO may therefore represent a valuable alternative to barbiturates. A randomized trial with these drug classes could definitively assess their respective role in RSE treatment.

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“…Propofol has been used since the early 1980s for anesthesia in the operation room and sedation in the intensive care unit as well as currently for refractory status epilepticus 18. It is highly lipid soluble and metabolized in the liver, and has very short distribution and short elimination half-life (30–60 min) and little propensity to accumulate 19.…”

Section: Discussionmentioning

confidence: 99%

Propofol Infusion Syndrome in Refractory Status Epilepticus

2013

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Background and Purpose:Propofol is used for treating refractory status epilepticus, which has high rate of mortality. Propofol infusion syndrome is a rare but often fatal syndrome, characterized by lactic acidosis, lipidemia, and cardiac failure, associated with propofol infusion over prolonged periods of time. We investigated the clinical factors that characterize propofol infusion syndrome to know the risk of them in refractory status epilepticus.Methods:This retrospective observation study was conducted in Samsung medical center from Jan. 2005 to Dec. 2009. Thirty two patients (19 males, 13 females, aged between 16 and 64 years), with refractory status epilepsy were included. Their clinical findings and treatment outcomes were evaluated retrospectively. We divided our patients into established status epilepticus (ESE) and refractory status epilepticus (RSE). And then the patients with RSE was further subdivided into propofol treatment group (RSE-P) and the other anesthetics treatment group (RSE-O). We analyzed the clinical characteristics by comparison of the groups.Results:There were significant differences of hypotension and lipid change between ESE and RSE (p<0.05). However, there was no significant difference between RSE-P and RSE-O groups. The hospital days were longer in RSE than in ESE (p=0.012) and treatment outcome was also worse in RSE than in ESE (p=0.007) but there were no significant differences of hospital stays and treatment outcome between RSE-P and RSE-O.Conclusions:RSE is very critical disease with high mortality, which may show as many clinical changes as propofol infusion syndrome. Therefore propofol infusion syndrome might be considered as one of the clinical manifestations of RSE.

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Preliminary Experience With Ici 35 868 as an I.V. Induction Agent: Comparison With Althesin

Cited by 42 publications

References 0 publications

Comparision of Ici 35868, Etomidate and Methohexitone for Day-Case Anaesthesia

Comparision of Ici 35868, Etomidate and Methohexitone for Day-Case Anaesthesia

Propofol Treatment of Refractory Status Epilepticus: A Study of 31 Episodes

Propofol Infusion Syndrome in Refractory Status Epilepticus

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