Understanding Anesthesiology - The Global Regional Anesthesia ...

Sodium Thiopental
Class
Short-acting barbiturate. Was used as an anesthetic induction agent but has largely been replaced
by propofol. It is also useful as an anticonvulsant or for the rapid reduction of elevated
intracranial pressure.
Mechanism of action
Decreases the rate of dissociation of the inhibitory neurotransmitter GABA from its receptors
resulting in depression of the reticular activating system.
Dose
3-5 mg/kg IV for healthy adults
5-6 mg/kg IV for children
7-8 mg/kg IV for infants
Dose must be reduced considerably in unstable or fragile patients.
Onset
Within one arm-brain circulation time (approximately 20 seconds).
Duration
Approximately 5-10 minutes after single induction dose.
Elimination
Rapid redistribution of drug from the central nervous system (CNS) to lean body tissue accounts
for the prompt awakening. The final elimination from the body depends on hepatic
metabolism and excretion by the kidneys.
Effects
CNS
Profound CNS depressant. Decreases cerebral metabolic rate and intracranial pressure. May
cause hypertonus, twitching and tremors during induction. May contribute to postoperative
confusion and delirium. Potentiates the depressant effects of opioids, sedatives, alcohol
and volatile anesthetics.
CVS
Depression of myocardial contractility and vasodilation leads to decreased cardiac output
and blood pressure with a mild compensatory tachycardia. Must be used with caution in patients
with poor left ventricular function or critical coronary artery insufficiency or in those
who are seriously ill or debilitated.
Respiratory
Depresses the rate and depth of breathing leading to brief period of apnea. Does not blunt
the airway’s response to manipulation therefore coughing, hiccoughing, laryngospasm and
bronchospasm may be seen at light planes of anesthesia.
GI
Nausea and vomiting
Misc.
Incompatible with drugs with acidic pH. For example, if given in the IV line with vecuronium
(a NDMR no longer in use), precipitation would occur. Arterial or extravascular injection produces
necrosis.
Contraindications
Porphyria
Related Glossary Terms
Etomidate, Induction, Ketamine, Propofol
Index
Find Term
Chapter 3 - General Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Drug Finder
Chapter 6 - Induction Agents