The immediate cardiovascular effects of Althesin (Glaxo CT 1341), a steroid induction agent, and thiopentone in man

Coleman, A.J.; Downing, J. W.; Leary, W. P.; Moyes, D. G.; Styles, M.

doi:10.1111/j.1365-2044.1972.tb08241.x

Cited by 20 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They concluded that the drug was contraindicated in patients with impaired coronary blood flow reserve. Other studies in healthy, unpremedicated adults have demonstrated similar increases in heart rate (Savege et al, 1971;Coleman et al, 1972). In contrast, previous work in premedicated patients with cardiac disease confirms the finding that there is no change in heart rate that can be attributed to Althesin (Lyons and Clarke, 1972;Broadley and Taylor, 1974).…”

Section: Discussionsupporting

confidence: 52%

A Comparison of Some Cardiorespiratory Effects of Althesin and Ketamine When Used for Induction of Anaesthesia in Patients With Cardiac Disease

Savege¹,

Colviin²,

Weaver

et al. 1976

British Journal of Anaesthesia

View full text Add to dashboard Cite

Cardiorespiratory effects of ketamine and Althesin were measured in two groups of premedicated patients with cardiac disease. The drugs were given in clinically equivalent doses with a second dose administered about 10 min after induction. The first dose of ketamine caused a marked increase in systemic and pulmonary arterial pressure, heart rate, and central venous and wedge pressures and cardiac index. The first dose of Althesin caused a decrease in systemic arterial pressure, central venous pressure, cardiac index and heart work, but little change in heart rate. The second dose of induction agent was administered before the cardiorespiratory effects of the initial dose had resolved. The second dose of Althesin caused changes similar to those following the first dose, but less marked. The changes following the second dose of ketamine were opposite to those following the first dose.

show abstract

Section: Discussionsupporting

confidence: 52%

A Comparison of Some Cardiorespiratory Effects of Althesin and Ketamine When Used for Induction of Anaesthesia in Patients With Cardiac Disease

Savege¹,

Colviin²,

Weaver

et al. 1976

British Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5][6][7] Depending on the rate of iniection, the maximum depressant effect on blood pressure occurs usually after two or three minutes, while recovery requires approximately 15 minutes. 8 The hypotension has been attributed to a reduction in peripheral resistance 4,6,'9 since cardiac output remains unaltered.…”

mentioning

confidence: 99%

The effects of althesin and thiopentone on sympathetic and baroreflex activity

Mackenzie

McGrath

Tétrault

et al. 1976

Canad. Anaesth. Soc. J.

View full text Add to dashboard Cite

ANAESTHESIA With the steroid agent Althesin is usually associated with reductions in arterial blood pressure. 1-7Depending on the rate of iniection, the maximum depressant effect on blood pressure occurs usually after two or three minutes, while recovery requires approximately 15 minutes. 8 The hypotension has been attributed to a reduction in peripheral resistance 4,6,'9 since cardiac output remains unaltered. 8,1~ Although myocardial contractility 11 and stroke volume 4,1~ are depressed, cardiac output remains constant due to a concomitant increase in heart rate. 8,5,r,l~ Large doses of Althesin prevent the reflex bradycadia in response to the pressor effect of adrenaline, suggesting that the baroreceptor reflex is impaired? 4 As the pressor effects of adrenaline TM and methoxamine a are unaffected by the drug, its action is unlikely to be a direct one on vascular smooth muscle.We have investigated the effects of Althesin on central sympathetic discharge and baroreceptor pathways, to clarify their influence on the circulatory responses observed. METHODSMale New Zealand white rabbits weighing 2.8 to 3.5 kg were anaesthetized with pentobarbitone, or were decerebrated. The latter procedure was carried out under anaesthesia with 3 per cent halothane in oxygen, following early insertion of a tracheal cannula. The accompanying arterial pressure drop restricted bleeding and rendered carotid clamping unnecessary. At least one hour was allowed to elapse after administration of halothane had been discontinued before the effects of Althesin or thiopentone were studied.In intact rabbits anaesthesia was induced with pentobarbitone 30 mg/kg given initially through the marginal ear vein, subsequent maintenance doses of 4 mg/kg being administered every 40 minutes through a femoral vein cannula.Following the preparatory period, gallamine 1 mg/kg was given intravenously every 40 minutes in all animals. Mechanical ventilation using a Harvard pump Model 613 with 100 per cent oxygen was adjusted to maintain end-tidal carbon dioxide at approximately 4 per cent as monitored with a Beckman LB-2 carbon dioxide analyzer. Arterial pressure was recorded from the femoral artery with a Bell and Howell transducer, and heart rate was obtained from the pressure channel by means of a Devices instantaneous ratemeter. These measurements were

show abstract

“…Despite some unwanted changes in physiological parameters, CT1341 was deemed safe as it did not cause side effects such as profound cardiovascular depression. 13,14 In the mid 1970s, there was a push to move away from the default use of inhalant anaesthetics since they are known to cause profound respiratory and cardiovascular depression. CT1341ʼs large therapeutic index and lack of cumulative effects helped pave the way for the use of intravenous anaesthetics as maintenance agents for total intravenous anaesthesia (TIVA).…”

Section: His Toric Al Per S Pec Tive S and Ba S I C Chemis Trymentioning

confidence: 99%

“…However, it also caused transient increased heart rate and drops in systolic and diastolic blood pressure. Despite some unwanted changes in physiological parameters, CT1341 was deemed safe as it did not cause side effects such as profound cardiovascular depression 13,14 …”

Section: Historical Perspectives and Basic Chemistrymentioning

confidence: 99%

Synthetic neuroactive steroids as new sedatives and anaesthetics: Back to the future

Manzella

Covey

Jevtović-Todorović

et al. 2022

J Neuroendocrinology

View full text Add to dashboard Cite

Since the 1990s, there has been waning interest in researching general anaesthetics (anaesthetics). Although currently used anaesthetics are mostly safe and effective, they are not without fault. In paediatric populations and neonatal animal models, they are associated with learning impairments and neurotoxicity. In an effort to research safer anaesthetics, we have gone back to re‐examine neuroactive steroids as anaesthetics. Neuroactive steroids are steroids that have direct, local effects in the central nervous system. Since the discovery of their anaesthetic effects, neuroactive steroids have been consistently used in human or veterinary clinics as preferred anaesthetic agents. Although briefly abandoned for clinical use due to unwanted vehicle side effects, there has since been renewed interest in their therapeutic value. Neuroactive steroids are safe sedative/hypnotic and anaesthetic agents across various animal species. Importantly, unlike traditional anaesthetics, they do not cause extensive neurotoxicity in the developing rodent brain. Similar to traditional anaesthetics, neuroactive steroids are modulators of synaptic and extrasynaptic γ‐aminobutyric acid type A (GABAA) receptors and their interactions at the GABAA receptor are stereo‐ and enantioselective. Recent work has also shown that these agents act on other ion channels, such as high‐ and low‐voltage‐activated calcium channels. Through these mechanisms of action, neuroactive steroids modulate neuronal excitability, which results in characteristic burst suppression of the electroencephalogram, and a surgical plane of anaesthesia. However, in addition to their interactions with voltage and ligand gated ions channels, neuroactive steroids interact with membrane bound metabotropic receptors and xenobiotic receptors to facilitate signaling of prosurvival, antiapoptotic pathways. These pathways play a role in their neuroprotective effects in neuronal injury and may also prevent extensive apoptosis in the developing brain during anaesthesia. The current review explores the history of neuroactive steroids as anaesthetics in humans and animal models, their diverse mechanisms of action, and their neuroprotective properties.

show abstract

The immediate cardiovascular effects of Althesin (Glaxo CT 1341), a steroid induction agent, and thiopentone in man

Cited by 20 publications

References 10 publications

A Comparison of Some Cardiorespiratory Effects of Althesin and Ketamine When Used for Induction of Anaesthesia in Patients With Cardiac Disease

A Comparison of Some Cardiorespiratory Effects of Althesin and Ketamine When Used for Induction of Anaesthesia in Patients With Cardiac Disease

The effects of althesin and thiopentone on sympathetic and baroreflex activity

Synthetic neuroactive steroids as new sedatives and anaesthetics: Back to the future

Contact Info

Product

Resources

About