Thiopental 500mg powder for solution for injection vials

Background and purposeGeneral anesthesia is indicated in emergencies, contraindications, or patient requests. The induction agent to use is an important factor in general anesthesia. We aim to provide an updated systematic review and meta-analysis to compare propofol, ketamine, and thiopental sodium in terms of efficacy and safety profiles in women undergoing cesarean sections under general anesthesia.MethodsWe conducted this systematic review and meta-analysis according to PRISMA guidelines. We searched the following databases (PubMed, Scopus, Cochran Library, and Web of Science) up to 18-8-2024. We used a term for cesarian section, thiopental, ketamine, and propofol.ResultsThirty-six randomized controlled trials met our criteria and were included in our analysis with a total of 1945 patients. In (Thiopentone vs. Propofol) group, the use of thiopentone was associated with higher umbilical artery PH and longer recovery duration, although the certainty of evidence was low for both outcomes, while in the propofol group, the risk of having neonates with Apgar score less than 7 at one minute was higher, but the certainty of evidence was very low. In (Thiopentone vs. Ketamine) group, patients induced with thiopentone reported accidental awareness during general anesthesia (AAGA) more frequently and their neonates revealed higher umbilical vein PvO2. Also, Apgar score ConclusionOur findings suggest that propofol and thiopentone appear to be clinically comparable. Ketamine was favored over thiopentone for its lower risk of AAGA, while thiopentone was associated with a lower risk of Apgar scores < 7 at 1 and 5 min. Additional well-designed trials are needed to support our conclusions more firmly.

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ObjectiveTo review and systematically analyse the literature describing the effects of anaesthesia drugs on puppy vitality scores or survival in dogs undergoing caesarean section.AnimalsOverall 13 randomized controlled trials (RCTs) involving 1978 puppies were included.MethodsA comprehensive search using PubMed, Embase and Scopus databases was performed from 1970 until September 2024 to obtain nonrandomized and RCTs examining the effects of anaesthetics on puppy survival rates or vitality scores after caesarean section in dogs. Only studies in English were screened. Search terms included: 'c-section' or 'caesarean section' and 'anaesthesia' and 'dog'. Two authors independently searched, classified and extracted the data. Studies were included if they evaluated the effects of anaesthesia drugs in dogs undergoing general anaesthesia and puppy survival or vitality scores. The level of evidence was scored according to the Oxford Centre for Evidence-based Medicine criteria, and a modified criterion score was used to assess the risk of bias based on the SYRCLE risk of bias tool and the SIGN checklists.ResultsMethodological characteristics varied considerably between studies, including drug doses, titration of anaesthetics, anaesthesia monitoring and puppy outcome scores. Ten studies assessed puppy vitality by using a modified Apgar score (AS). A high risk of bias was identified in six studies, whereas three had a low risk of bias. The scarcity of methodologically consistent studies and the quality of data limit identification of an optimal anaesthetic regimen to improve puppy survival. Low doses of morphine, methadone, dexmedetomidine or meloxicam preoperatively did not produce a significant impact on puppy vitality. Ketamine-midazolam, etomidate or thiopental appear to worsen immediate neonatal outcomes. No difference in neonatal survival was found between alfaxalone and propofol, but AS were higher with alfaxalone than with propofol immediately after birth.ConclusionsThe use of injectable anaesthetics for maintenance of anaesthesia led to lower puppy vitality.

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Background: Remifentanil, an ultra-short-acting μ-receptor agonist, is used with propofol or thiopental for tracheal intubation without muscle relaxants. While effective with both, its combination with thiopental provides better hemodynamic stability. Thiopental has long been a standard intravenous agent for anaesthesia induction and remains a cost-effective alternative to propofol in resource-limited settings. To date, no study has directly compared the effects of thiopental-remifentanil and propofol-remifentanil combinations on LMA insertion conditions. This study aims to compare the effects of thiopental or propofol with 2 µg·kg-1 remifentanil on laryngeal mask airway (LMA) insertion conditions and success in a prospective, randomised double-blind study. Method: The study included 80 premedicated ASA I-II patients, aged 18-65, randomised into Group P (propofol) and Group T (thiopental). Anaesthesia induction was with 2 μg·kg-1 remifentanil, followed by 5 mg·kg-1 thiopental or 2.5 mg·kg-1 propofol. LMA insertion occurred 90 s post-induction. LMA insertion conditions were evaluated using a six-variable scale. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and bispectral index monitor (BIS) values were recorded at baseline, 1 min pre-insertion, and at 1, 2, 3, 4, and 5 min after insertion. Apnoea duration, loss of eyelash reflex duration, insertion duration, number of attempts, and perioperative complications were also documented. Results: Demographic data were similar. Group P showed significantly shorter eyelash reflex loss and LMA insertion durations, longer apnoea duration, and higher rates of full mouth opening, excellent LMA insertion condition, and hypotension or bradycardia compared to Group T (p p p > 0.05). Conclusions: In our study, administration of 2 μg·kg-1 remifentanil before induction along with thiopental or propofol was shown to provide acceptable LMA insertion conditions at comparable levels. As hemodynamic parameters were less affected, we believe the remifentanil-thiopental combination may be a suitable alternative.

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