Thiopental

Anaesthetic · General anaesthetic

Indications

Induction of general anaesthesia; anaesthesia of short duration; reduction of raised intracranial pressure if ventilation controlled; status epilepticus.

Dosage

Induction of general anaesthesia: By slow IV injection usually as a 2.5% (25 mg/mL) solution. Adults: over 18 yr, fit and pre-medicated, initially 100- 150 mg (reduced in elderly or debilitated) over 10-15 sec (longer in elderly or debilitated), followed by further quantity if necessary according to response after 30-60 sec; or up to 4 mg/kg (max 500 mg). Children: 1 mth-18 yr, initially up to 4 mg/kg then 1 mg/kg repeated as necessary (max total dose 7 mg/kg). Raised intracranial pressure: By slow IV injection, 1.5-3 mg/kg, repeated as required. Status epilepticus: (only if other measures fail), By slow IV injection as a 2.5% (25 mg/mL) solution. Adults: Over 18 yr, 75-125 mg as a single dose. Children: 1 mth-18 yr, initially up to 4 mg/kg by slow IV injection, then up to 8 mg/kg/hr by continuous IV infusion, adjusted according to response.

Administration

Administered by slow IV infusion only. For intermittent IV administration, the continuous used range between 2% and 5% in SWFI, dextrose 5%, NaCl 0.9%, with 2% or 2.5% being the most common. By continuous IV drip, concentrations of 0.2% or 0.4% in dextrose 5%, NaCl 0.9%, or a pH 7.4 combined electrolyte solution are used. Do not use SWFI to prepare thiopental sodium solutions less than 2% because such solutions would be very hypotonic and would cause haemolysis. Reconstitution: Reconstitute in SWFI or NaCl 0.9%, Stability: Store under refrigerator and tightly sealed for 7 days. Store at room temperature for 3 days.

Adverse Effects

Hypotension, arrhythmias, myocardial depression, laryngeal spasm, cough, headache, sneezing, hypersensitivity reactions, rash.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Contraindications: Acute porphyria; myotonic dystrophy. Precautions: Cardiovascular disease; reconstituted solution is highly alkaline-extravasation causes tissue necrosis and severe pain; avoid intra-arterial injection.

Interactions

See literature.

Pharmacokinetics

Onset: Rectal: 8-10 mins. Absorption: Rapidly absorbed. Metabolism: Hepatic. Half-life elimination: Terminal: Adults: 10-12 hrs. Children: 6 hrs. Excretion: Urine (mainly).

Brands with this active ingredient

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