Quercetin increases the antidepressant-like effects of sclareol and antagonizes diazepam in thiopental sodium-induced sleeping mice: A possible GABAergic transmission intervention.

Quercetin is the most common polyphenolic flavonoid present in fruits and vegetables demonstrating versatile health-promoting effects. This study aimed to examine the effects of quercetin (QR) and sclareol (SCL) on the thiopental sodium (TS)-induced sleeping and forced swimming test (FST) mouse models. SCL (1, 5, and 10 mg/kg, p.o.) or QR (50 mg/kg, p.o.) and/or diazepam (DZP) (3 mg/kg, i.p.) were employed. After 30 min of TS induction, individual or combined effects on the animals were checked. In the FST test, the animals were subjected to forced swimming after 30 min of administration of the test and/or controls for 5 min. In this case, immobility time was measured. In silico studies were conducted to evaluate the involvement of GABA receptors. SCL (5 and 10 mg/kg) significantly increased the latency and decreased sleeping time compared to the control in the TS-induced sleeping time study. DZP (3 mg/kg) showed a sedative-like effect in animals in both sleeping and FST studies. QR (50 mg/kg) exhibited a similar pattern of activity as SCL. However, its effects were more prominent than those of SCL groups. SCL (10 mg/kg) altered the DZP-3-mediated effects. SCL-10 co-treated with QR-50 significantly (p < 0.05) increased the latency and decreased sleep time and immobility time, suggesting possible synergistic antidepressant-like effects. In silico studies revealed that SCL and QR demonstrated better binding affinities with GABAA receptor, especially α2, α3, and α5 subunits. Both compounds also exhibited good ADMET and drug-like properties. In animal studies, the both compounds worked synergistically to provide antidepressant-like effects in a slightly different fashion. As a conclusion, the combined administration of SCL and QR may be used in upcoming neurological clinical trials, according to in vivo and in silico findings. However, additional investigation is necessary to verify this behavior and clarify the potential mechanism of action.

The dosage of thiopental as pharmacological cerebral protection during non-shunt carotid endarterectomy: A retrospective study.

Background: Thiopental has been used as a pharmacological cerebral protection strategy during carotid endarterectomy surgeries. However, the optimal dosage required to induce burst suppression on the electroencephalogram (EEG) remains unknown. This retrospective study aimed to determine the optimal dosage of thiopental required to induce burst suppression during non-shunt carotid endarterectomy. Methods: The Neurological Institute of Thailand Review Board approved the study. Data were collected from 2009 to 2019 for all non-shunt carotid endarterectomy patients who received thiopental for pharmacological cerebral protection and had intraoperative EEG monitoring. Demographic information, carotid stenosis severity, intraoperative EEG parameters, thiopental dosage, carotid clamp time, intraoperative events, and patient outcomes were abstracted. Results: The study included 57 patients. Among them, 24 patients (42%) achieved EEG burst suppression pattern with a thiopental dosage of 26.3±10.1 mg/kg/hr. There were no significant differences in perioperative events between patients who achieved burst suppression and those who did not. After surgery, 33.3% of patients who achieved burst suppression were extubated and awakened. One patient in the non-burst suppression group experienced mild neurological deficits. No deaths occurred within one month postoperative. Conclusions: The optimal dosage of thiopental required to achieve burst suppression on intraoperative EEG during non-shunt carotid endarterectomy was 26.3±10.1 mg/kg/hr.

Thiopental sodium attenuates hypoxia/reoxygenation-induced injury in osteoblasts by modulating AKT signaling.

Thiopental sodium (TPTS) is a barbiturate general anesthetic, while its effects on hypoxia/reoxygenation (H/R)-induced injury are still unclear. This study aimed to investigate whether TPTS exerts protective effects against the H/R-induced osteoblast cell injury and explore the underlying mechanisms. Osteoblast cell injury model was induced by the H/R condition, which was treated with or without TPTS. Cell viability and lactate dehydrogenase (LDH) release were determined by the corresponding commercial kits. The levels of oxidative stress were determined in the experimental groups. Cell apoptosis and Caspase-3 activities were determined by propidium iodide staining and substrate-based assay, respectively. Western blotting and qRT-PCR were performed to measure the mRNA and protein levels, respectively. Treatment with TPTS was able to increase cell viability and reduce LDH release in H/R-induced osteoblasts. Additionally, TPTS regulated oxidative stress in H/R-induced osteoblasts by suppressing malondialdehyde (MDA) and reactive oxygen species (ROS) as well as boosting superoxide dismutase (SOD). TPTS was able to suppress cell apoptosis by suppressing Caspase-3 activity and cleavage. TPTS exerted protective effects against cell injury and apoptosis induced by the H/R conditions, which were associated with its regulation of Akt signaling. Moreover, TPTS induced osteoblast differentiation under the H/R condition. In summary, TPTS attenuates H/R-induced injury in osteoblasts by regulating AKT signaling.

Effects of ketamine, thiopental and their combination on the rat liver: A biochemical evaluation.

BACKGROUND: In the literature, it has been suggested that ketamine-related oxidative organ damage results from increased blood adrenaline level, and thiopental-related oxidative damage is caused by decreased adrenaline level, suggesting that ketamine-thiopental combination (KT) may be beneficial in reducing the hepatotoxic effect of ketamine. OBJECTIVES: To biochemically investigate the effects of ketamine, thiopental and KT on the liver in rats. MATERIAL AND METHODS: Male albino Wistar type rats received intraperitoneally (ip.) 30 mg/kg ketamine in the ketamine alone (KG) group (n = 6), 15 mg/kg thiopental in the thiopental alone (TG) group (n = 6), and 30 mg/kg ketamine + 15 mg/kg thiopental in the ketamine+thiopental (KTG) group (n = 6). The same volume of distilled water as solvent was given to the healthy (HG) animal group. This procedure was repeated once daily for 30 days. At the end of this period, the animals were killed by decapitation and their livers were removed. In liver tissue, malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1ß), and interleukin-6 (IL-6) levels were measured. The IL-1ß, IL-6, TNF-α, adrenalin (ADR), noradrenalin (NDR), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were determined in blood samples taken from the tail veins. RESULTS: In the group treated with ketamine and thiopental alone, MDA, TOS, IL-1ß, IL-6, TNF-α, ADR, NDR, ALT, and AST levels were found to be high, and those of tGSH and TAS to be low. However, there was no significant change in the levels of these parameters in the KTG. CONCLUSIONS: These results indicate that oxidative stress and inflammation developed in the liver tissue of the group that used ketamine and thiopental alone, suggesting that the KT form may be safer in terms of toxicity in the clinical usage.

Adequacy of maternal anesthesia depth with two sodium thiopental doses in elective caesarean section: a randomized clinical trial.

BACKGROUND: Administration of an optimal dose of anesthetic agent to ensure adequate depth of hypnosis with the lowest risk of adverse effects to the fetus is highly important in cesarean section. Sodium thiopental (STP) is still the first choice for induction of anesthesia in some countries for this obstetric surgery. We aimed to compare two doses of STP with regarding the depth of anesthesia and the condition of newborn infants. METHODS: In this clinical trial, parturient undergoing elective Caesarian section were randomized into two groups receiving either low-dose (5 mg/kg) or high-dose (7 mg/kg) STP. Muscle relaxation was provided with succinylcholine 2 mg/kg and anesthesia was maintained with O2/N2O and sevoflurane. The depth of anesthesia was evaluated using isolated forearm technique (IFT) and bispectral index (BIS) in various phases. Additionally, infants were assessed using Apgar score and neurobehavioral test. RESULTS: Forty parturient were evaluated in each group. BIS was significantly lower in high-dose group at skin incision to delivery and subcutaneous and skin closure. Also, significant differences were noticed in IFT over induction to incision and incision to delivery. Apgar score was significantly lower in high-dose group at 1 min after delivery. Newborn infants in low-dose group had significantly better outcomes in all three domains of the neurobehavioral test. CONCLUSION: 7 mg/kg STP is superior to 5 mg/kg in creating deeper hypnosis for mothers. However, it negatively impacts Apgar score and neurobehavioral test of neonates. STP seems to has dropped behind as an acceptable anesthetic in Cesarean section. TRIAL REGISTRATION: IRCT No: 2016082819470 N45 , 13/03/2019.

A Comparison Between Thiopental Sodium and Propofol for Induction of Anesthesia in Elective Cesarean Section Using Bispectral Index and Isolated Forearm Technique: A Randomized, Double-Blind Study

Objective: Although regional anesthesia is the most frequently used method for selected surgical approaches, general anesthesia (GA) is still common. Awareness and recall of events are among the main hazards during GA, particularly in Caesarean Section (C/S). In this study, we decided to compare depth of anesthesia, that was measured by Bispectral index (BIS) and isolated forearm technique (IFT) in GA, induced by propofol vs. thiopental for elective C/S. We also aimed to determine the incidence of postoperative recall using these two anesthetic medications. Methods: Ninety parturient were allocated to receive either thiopental (group T) or propofol (group P) with blocking on a 1:1 ratio. All patients underwent standard GA. BIS and IFT were used to monitor depth of anesthesia at different predetermined perioperative events. All patients were evaluated for recall of the events. Results: No patient recalled the perioperative events during the follow up period. BIS scores were significantly lower in group P compared with group T after induction of GA until discontinuation of volatile anesthetics (p < 0.001). IFT values were signifi cantly higher in thiopental group in time interval of induction to skin incision comparing to propofol group (p < 0.050). Conclusion: The current study suggests regarding better effect of propofol on decreasing of awareness during anesthesia and surgery, it seems to be better to use propofol in cases where we are forced to use GA in cesarean section.

Effects of thiopentone, propofol and alfaxalone on laryngeal motion during oral laryngoscopy in healthy dogs.

OBJECTIVE: To compare the effects of thiopentone, propofol and alfaxalone on arytenoid cartilage motion and establish the dose rates to achieve a consistent oral laryngoscopy examination. STUDY DESIGN: Randomised crossover study. ANIMALS: Six healthy adult Beagle dogs. METHODS: Each dog was randomly administered three induction agents with a 1-week washout period between treatments. Thiopentone (7.5 mg kg-1), propofol (3 mg kg-1) or alfaxalone (1.5 mg kg-1) was administered over 1 minute for induction of anaesthesia. If the dog was deemed inadequately anaesthetised, then supplemental boluses of 1.8, 0.75 and 0.4 mg kg-1 were administered, respectively. Continual examination of the larynx, using a laryngoscope, commenced once an adequate anaesthetic depth was reached until examination end point. The number of arytenoid motions and vital breaths were counted during three time periods and compared over time and among treatments. Data were analysed using Friedman and Mann-Whitney U tests, Spearman rho and a linear mixed model with post hoc pairwise comparison with Tukey correction. RESULTS: The median (range) induction and examination times were 2.8 (2.0-3.0), 2.7 (2.0-3.3) and 2.5 (1.7-3.3) minutes (p = 0.727); and 14.1 (8.0-41.8), 5.4 (3.3-14.8) and 8.5 (3.8-31.6) minutes (p = 0.016) for thiopentone, propofol and alfaxalone, respectively. The median dose rates required to achieve an adequate anaesthetic depth were 6.3 (6.0-6.6), 2.4 (2.4-2.4) and 1.2 (1.2-1.2) mg kg-1 minute-1, respectively. There was no significant difference for the total number of arytenoid motions (p = 0.662) or vital breaths (p = 0.789) among induction agents. CONCLUSION AND CLINICAL RELEVANCE: The number of arytenoid motions were similar among the induction agents. However, at the dose rates used in this study, propofol provided adequate conditions for evaluation of the larynx with a shorter examination time which may be advantageous during laryngoscopy in dogs.

Resting-state functional MRI as a tool for evaluating brain hemodynamic responsiveness to external stimuli in rats.

PURPOSE: Anesthesia is a major confounding factor in functional MRI (fMRI) experiments attributed to its effects on brain function. Recent evidence suggests that parameters obtained with resting-state fMRI (rs-fMRI) are coupled with anesthetic depth. Therefore, we investigated whether parameters obtained with rs-fMRI, such as functional connectivity (FC), are also directly related to blood-oxygen-level-dependent (BOLD) responses. METHODS: A simple rs-fMRI protocol was implemented in a pharmacological fMRI study to evaluate the coupling between hemodynamic responses and FC under five anesthetics (α-chloralose, isoflurane, medetomidine, thiobutabarbital, and urethane). Temporal change in the FC was evaluated at 1-hour interval. Supplementary forepaw stimulation experiments were also conducted. RESULTS: Under thiobutabarbital anesthesia, FC was clearly coupled with nicotine-induced BOLD responses. Good correlation values were also obtained under isoflurane and medetomidine anesthesia. The observations in the thiobutabarbital group were supported by forepaw stimulation experiments. Additionally, the rs-fMRI protocol revealed significant temporal changes in the FC in the α-chloralose, thiobutabarbital, and urethane groups. CONCLUSION: Our results suggest that FC can be used to estimate brain hemodynamic responsiveness to stimuli and evaluate the level and temporal changes of anesthesia. Therefore, analysis of the fMRI baseline signal may be highly valuable tool for controlling the outcome of preclinical fMRI experiments. Magn Reson Med 78:1136-1146, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Etomidate, but not thiopental, decreases serum cortisol concentration in morbidly obese patients. A randomized controlled trial.

BACKGROUND: The effect of etomidate administration on the adrenal cortex in obese patients is still unclear. The objective of the study was to determine the influence of a single dose of etomidate on cortisol secretion in the morbidly obese. METHODS: 127 healthy patients were enrolled into the study. Data from 82 patients scheduled for elective laparoscopic surgery were analyzed. 62 of them were morbidly obese, while 20 had normal body mass. The participants were divided equally into etomidate and thiopental groups, depending on the kind of intravenous anaesthetic used for the induction of anaesthesia. Each patient's serum cortisol concentration was measured five times: on the day before surgery (sample A), two hours after the induction of anaesthesia (sample B), after a short tetracosactide test (sample C), 24 hours after the induction of anaesthesia (sample D), and after a second short stimulation test (sample E). RESULTS: The mean cortisol concentration in obese patients in the etomidate group was lower two hours after the induction of anaesthesia (sample B, P < 0.001), and 30 minutes after the first tetracosactide test (sample C, P < 0.001) compared to obese patients in the thiopental group. There were no differences between the groups in sample A (P = 0.833), D (P = 0.614) and E (P = 0.769). We found no changes in haemodynamic parameters between both groups. CONCLUSIONS: Etomidate decreased serum cortisol concentration and decreased reactivity to tetracosactide both in morbidly obese and in normal weight patients. This effect was reversible within 24 hours.

Effect of different anesthetic agents on left ventricular systolic function assessed by echocardiography in hamsters

Determination of left ventricular ejection fraction (LVEF) using in vivo imaging is the cardiac functional parameter most frequently employed in preclinical research. However, there is considerable conflict regarding the effects of anesthetic agents on LVEF. This study aimed at assessing the effects of various anesthetic agents on LVEF in hamsters using transthoracic echocardiography. Twelve female hamsters were submitted to echocardiography imaging separated by 1-week intervals under the following conditions: 1) conscious animals, 2) animals anesthetized with isoflurane (inhaled ISO, 3 L/min), 3) animals anesthetized with thiopental (TP, 50 mg/kg, intraperitoneal), and 4) animals anesthetized with 100 mg/kg ketamine plus 10 mg/kg xylazine injected intramuscularly (K/X). LVEF obtained under the effect of anesthetics (ISO=62.2±3.1%, TP=66.2±2.7% and K/X=75.8±1.6%) was significantly lower than that obtained in conscious animals (87.5±1.7%, P<0.0001). The K/X combination elicited significantly higher LVEF values compared to ISO (P<0.001) and TP (P<0.05). K/X was associated with a lower dispersion of individual LVEF values compared to the other anesthetics. Under K/X, the left ventricular end diastolic diameter (LVdD) was increased (0.60±0.01 cm) compared to conscious animals (0.41±0.02 cm), ISO (0.51±0.02 cm), and TP (0.55±0.01 cm), P<0.0001. The heart rate observed with K/X was significantly lower than in the remaining conditions. These results indicate that the K/X combination may be the best anesthetic option for the in vivo assessment of cardiac systolic function in hamsters, being associated with a lower LVEF reduction compared to the other agents and showing values closer to those of conscious animals with a lower dispersion of results.

Sonographic optic nerve sheath diameter as a surrogate measure for intracranial pressure in anesthetized patients in the Trendelenburg position.

BACKGROUND: It remains to be elucidated whether the Trendelenburg position increases intracranial pressure (ICP). ICP can be evaluated by measuring the sonographic optic nerve sheath diameter (ONSD). We investigated the effect of the isolated Trendelenburg position on ONSD in patients undergoing robot-assisted laparoscopic radical prostatectomy. Additionally, we evaluated the effect of the Trendelenburg position combined with pneumoperitoneum on ONSD. METHODS: Twenty-one patients scheduled for robot-assisted laparoscopic radical prostatectomy were enrolled. Sonographic ONSDs and hemodynamic parameters were measured at specific time points: in the supine position after induction of anesthesia, 3 min after the steep Trendelenburg position (35° incline), 3 min after the steep Trendelenburg position combined with pneumoperitoneum, and in the supine position after desufflation of the pneumoperitoneum. RESULTS: The ONSD 3 min after the steep Trendelenburg position was significantly higher than that of the supine position after induction of anesthesia (5.1 ± 0.3 mm vs. 4.5 ± 0.4 mm). In addition, the ONSD 3 min after the steep Trendelenburg position combined with pneumoperitoneum was higher than that of the supine position after induction of anesthesia (4.9 ± 0.4 mm vs. 4.5 ± 0.4 mm). The ONSD in the supine position after desufflation of the pneumoperitoneum was similar to that in the supine position after induction of anesthesia. CONCLUSIONS: Use of the isolated steep Trendelenburg position, for even a short duration, increased the sonographic ONSD, providing a better understanding of the effect of only a transient steep Trendelenburg position on ONSD as a surrogate measure for ICP.

Changes in intraocular pressures during laparoscopy: a comparison of propofol total intravenous anesthesia to desflurane-thiopental anesthesia.

The aim of the study was to examine intraocular pressure (IOP) changes during laparoscopic cholecystectomy performed under either desflurane-thiopental anesthesia or propofol total intravenous anesthesia (TIVA). 36 patients who will undergo elective laparoscopic cholecystectomy were enrolled in the study. The patients were randomly divided into one of two groups: desflurane (Group D, n=18) or propofol (Group P, n=18). All patients received fentanyl 2 micro/kg IV, and then breathed 100% oxygen for 3 minutes prior to induction of anesthesia. Anesthesia was induced by using thiopental 5 mg/kg IV in Group D and 2 mg/kg IV propofol in group P. Neuromuscular block was achieved with rocuronium 0.6 mg/kg IV. Anesthesia was maintained with desflurane 3-6% in group D and propofol infusion 5-10 mg/kg/h in group P. Desflurane and propofol concentrations were adjusted to maintain mean arterial pressure witihin 20% of the preinduction value. During anaesthesia, fractionated doses of fentanyl 0.5-1 micro g /kg IV and maintenance doses of muscle relaxants were used. In both groups, the the mixture 60% nitrous oxide and 40% oxygen was administered used. Arterial pressure, heart rate, ETCO2, SpO2 and IOP were recorded at the predefined time points. Creation of pneumoperitoneum resulted in a significant increase in IOP which remained elevated throughout the operation in both groups. Also, we recorded a similar IOP changes with both techniques except at five minutes after pneumoperitoneum in 15 degrees reverse Trendelenburg position during desflurane-thiopental anesthesia. In c6nclusion, desflurane-thiopental anesthesia maintains the IOP at least at similar levels compared to propofol TIVA anesthesia.

Pharmacology of intravenous sedative/anesthetic medications used in oral surgery.

This article provides an overview of historical and current sedative agents available to the dentist anesthetist. The surgeon is given rational choices for sedation and the individualization of drug selection for each patient. Total intravenous anesthesia is becoming increasingly popular for dental sedation because of the availability of ultra-short-acting drugs and computerized infusion technology. Levels of sedation are more easily achieved and maintained, and recovery is enhanced, which gives the operator extreme, moment-to-moment control of the anesthetic experience and improves patient outcomes.

Propofol and thiopental suppress amyloid fibril formation and GM1 ganglioside expression through the γ-aminobutyric acid A receptor.

BACKGROUND: The incidence of Alzheimer disease may increase after surgical interventions. Amyloid ß-protein (Aß) fibrillogenesis, which is closely related to Alzheimer disease, is reportedly accelerated by exposure to anesthetics. However, the effects of GM1 ganglioside (GM1) on Αß fibrillogenesis have not yet been reported. The current study was designed to examine whether the anesthetics propofol and thiopental are associated with Αß assembly and GM1 expression on the neuronal cell surface. METHODS: PC12N cells and cultured neuronal cells were treated with propofol or thiopental, and GM1 expression in treated and untreated cells was determined by the specific binding of horseradish peroxidase-conjugated cholera toxin subunit B (n = 5). The effects of an inhibitor of the γ-aminobutyric acid A receptor was also examined (n= 5). In addition, the effects of the anesthetics on GM1 liposome-induced Αß assembly were investigated (n = 5). Finally, the neurotoxicity of the assembled Αß fibrils was studied by the lactate dehydrogenase release assay (n = 6). RESULTS: Propofol (31.2 ± 4.7%) and thiopental (34.6 ± 10.5%) decreased GM1 expression on the cell surface through the γ-aminobutyric acid A receptor. The anesthetics inhibited Αß fibril formation from soluble Αß in cultured neurons. Moreover, propofol and thiopental suppressed GM1-induced fibril formation in a cell-free system (propofol, 75.8 ± 1.9%; thiopental, 83.6 ± 1.9%) and reduced the neurotoxicity of a mixture containing Aß and GM1 liposomes (propofol, 35.3 ± 16.4%; thiopental, 21.3 ± 11.6%). CONCLUSIONS: Propofol and thiopental have direct and indirect inhibitory effects on Αß fibrillogenesis.

Tourniquet-induced ischemia-reperfusion injuries during extremity surgery at children's age: impact of anesthetic chemical structure.

OBJECTIVES: The aim of this study was to determine the relationship between the antioxidant profile of anesthetics and its relation to total antioxidant capacity (TAC) of plasma in children who underwent tourniquet-induced ischemia-reperfusion (IR) injury during extremity operations. METHODS: Children were randomized into three groups: general inhalational anesthesia with sevoflurane (group S), total intravenous anesthesia (TIVA) with propofol (group T), and regional anesthesia (group R). Venous blood samples were obtained before peripheral nerve block and induction of general anesthesia (baseline), 1 minute before tourniquet release (BTR), and 5 and 20 minutes after tourniquet release (ATR). Plasma TAC as well as antioxidant potential of propofol, thiopental, and bupivacaine were measured using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. RESULTS: Plasma TAC in group T was increased significantly at 20 minutes ATR in comparison with basal and BTR values, and also was significantly higher in comparison with plasma TAC in groups S and R measured at the same time point. The radical scavenging activity of anesthetics in vitro indicated that only propofol possessed a significant antioxidative activity in the reaction with DPPH radical in comparison with thiopental and bupivacaine. DISCUSSION: These data confirm that TIVA with propofol attenuates oxidative stress related to tourniquet-induced ischaemia-reperfusion injury in children.

A prospective, randomized comparison of the effects of thiopental and propofol on bispectral index during caesarean section till delivery of newborn.

BACKGROUND: Since in caesarean operations skin incision to delivery time is very short, induction agent could be still effective on BIS level till the time of delivery. Therefore this study was designed to analyze the effect on maintaining adequate bispectral index levels till delivery of neonate of propofol and thiopental as an induction agent for caesarean section. METHODS: Eighty two patients undergoing caesarean section were allocated into two groups. In the group T anesthesia induction was performed with thiopental (5 mg/kg) and in the group P with propofol (2.5 mg/kg). Anesthesia was maintained with sevoflurane. Heart rates, blood pressures and BIS values during significant events of surgery and anesthesia till delivery, durations of surgery, induction to skin incision and to delivery and Apgar scores were recorded. For statistical analysis T-test was used for comparison of means of independent samples. RESULTS: The groups were comparable with respect to age, weight and gestational age. The patients in the group P had significantly lower levels of bispectral index values during uterus incision; 40.6 vs. 59.5 (p = 0.019) and delivery; 41 vs. 62.9 (p = 0.018). CONCLUSION: Anesthesia induction with propofol in a dose of 2.5 mg/kg maintains lower levels of heart rate, blood pressure and BIS till delivery when compared with thiopental in a dose of 5 mg/kg. There is no financial support taken from any kind of company or person. There are no financial relationships between authors and commercial interests with a vested interest in the outcome of study.

Thiopental-induced burst suppression measured by the bispectral index is extended during propofol administration compared with sevoflurane.

BACKGROUND: Thiopental is used to suppress cerebral metabolism during temporary clip ligation of the cerebral arteries. Electroencephalogram (EEG) can measure intraoperative burst suppression as evidence of cerebral metabolic suppression, but EEG is not always available during clip ligation. This study was conducted to compare the effect of propofol-based total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia on thiopental-induced burst suppression during aneurysm surgery. The effect of thiopental was measured by burst suppression ratio (BSR) using the bispectral index (BIS) monitor. METHODS: Forty-six patients who underwent temporary clipping during aneurysm surgery were randomized into 2 groups. The inhalation group (n=21) received sevoflurane-N(2)O anesthesia and the TIVA group (n=25) received propofol-remifenatanil-N(2)O anesthesia. The anesthesia level maintained a BIS value between 40 and 55. Pharmacological burst suppression was induced with bolus administration of thiopental (5 mg/kg) before temporary clipping. The BIS number, BSR values, the onset time and duration of BSR, and hemodynamic variables were recorded every minute in both groups. RESULTS: There were no significant differences between groups in the onset time of burst suppression (P=0.394) and BIS changes (P=0.878). However, statistically significant longer duration (P<0.001) and significantly higher degree of burst suppression (P=0.006) were observed in the TIVA group compared with the inhalation group. CONCLUSIONS: Our results suggest that at equivalent BIS values TIVA with propofol anesthesia provides longer duration and greater cerebral metabolic suppression compared with sevoflurane-N(2)O inhalation anesthesia. BIS may be an acceptable alternative to standard EEG monitoring when assessing burst suppression during temporary clipping.

Oxidative stress due to anesthesia and surgical trauma and comparison of the effects of propofol and thiopental in dogs.

The present study aimed to evaluate the effect of propofol and thiopental on the plasma oxidant-antioxidant profile in dogs undergoing surgery at doses used to induce anesthesia. The plasma total oxidant status (TOS) and oxidative stress index (OSI) levels increased significantly with time in both groups, whereas the plasma total antioxidant status (TAS) levels decreased with time in both groups. The OSI was significantly higher at the end of surgery than before induction of anesthesia in both groups. The TOS and OSI change ratio of propofol group were significantly lower than that of thiopental group. In conclusion, our findings show that propofol has antioxidant effects in dogs. Further studies need to be conducted to demonstrate the exact mechanism of oxidative stress due to anesthesia and surgery in dogs.

Estudio de los efectos de la asociación Ketamina-tiopental como co-inductores en los distintos periodos de la anestesia general / Study of the effects of ketamine-thiopental partnership as co-inducers in different periods of general anesthesia

La asociación de drogas tiene como finalidad potenciar efectos benéficos y disminuir reacciones adversas, esta investigación pretendió demostrar los efectos de la asociación de Tiopental sódico mas ketamina en dosis subterapeuticas, comparándola con Tiopental sódico en la inducción de la anestesia general para colecistectomías electivas y de urgencia, enfocando el efecto en la analgesia posoperatoria en sala de recuperación posanestesica. Estudio de investigación clínica, estadístico-prospectivo, doble ciego, 150 pacientes, 75 del grupo K, Ketamina 0,8 mg /kg EV mas Tiopental sódico 2 mg/kg EV y 75 del grupo T, Tiopental sódico 5 mg/kg EV, en ambos grupos se administró Anestesia General Balanceada, se valoró calidad de analgesia posoperatoria mediante, el tiempo de analgesia, escala visual numérica para intensidad del dolor y dosis de Morfina suplementaria como dosis rescate en el posoperatorio. Ambos grupos poblacionales fueron similares, con parámetros hemodinámicos y efectos adversos sin diferencia estadísticamente significativa. El tiempo analgésico, definido como el tiempo transcurrido hasta la necesidad de la primera dosis analgésica posoperatoria fue mayor en el grupo K comparado con el grupo T (media 194,64 min. EE 12,00 vs 143,54 EE 7,52 p 0,0001). Escala visual numérica = 3 se presento en el grupo K con diferencia significativa (p 0,0092) y el promedio del consumo total de morfina también fue menor en el grupo K 3.12 mg (EE 0.59) y en el grupo T 6.15mg (E 0.67) obteniéndose p: 0.00001. En este trabajo de investigación la Ketamina demostró marcado efecto en la analgesiaposoperatoria de la población estudiada, no solo por su efecto antagónico de los receptores N.M.D.A, receptores involucrada en la transmisión del dolor sino también por su interacción con receptores opioides, lo cual es concordante con la bibliografía consultada. Su metabolito Norketamina potencia el efecto opioide y potencia el efecto ntinociceptivo de la Morfina

SUMMARY: The association aims to enhance drugs beneficial effects and reduce adverse reactions, this research seeks to demonstrate the effects of the association of sodium thiopental with ketamine subtherapeutic, compared with sodium thiopental for induction of general anesthesia for elective and emergency cholecystectomies , focusing on the effect on postoperative analgesia in recovery room postanesthesic. Clinical research study, statistical-prospective, double blind, 150 patients, 75 of Group K, ketamine 0.8 mg / kg sodium thiopental EV 2 mg / kg group and 75 EV T thiopental sodium 5 mg / kg IV, in both groups were given general anesthesia, was assessed by postoperative quality of analgesia, analgesia duration, visual numeric scale for pain intensity and supplemental morphine as rescue doses postoperatively. Both populations were similar, with adverse hemodynamic and no statistically significant difference. The analgesic time, defined as time to first need for postoperative analgesic dose was higher in group K than in group T (mean 194.64 min. 12.00 vs 143.54 EE EE 7.52 p 0, 0001). Visual numeric scale = 3 is presented in the K group with significant difference (p 0.0092) and mean total morphine consumption was also lower in group K 3.12 mg (SD 0.59) and in group T 6.15mg (E 0.67) to obtain p: 0.00001. In this research work, ketamine showed marked effect in postoperative analgesia of the population studied, not only by its antagonistic effect of NMDA receptors, receptors involved in pain transmission but also by their interaction with opioid receptors, which is consistent with the literature. Norketamine metabolite enhances the effect and power opioip antinociceptive effect of morphine