title: Thiopental loading during controlled hypotension for intracranial aneurysm surgery.
abstract: In this study we report our clinical experience with supplementary thiopental loading, based on 30 patients undergoing surgery for intracranial aneurysm after a recent episode of subarachnoid haemorrhage. As standard procedure we used pentobarbitone induction, pancuronium relaxation, endotracheal intubation, maintenance with halothane 0.5%, N2O 66% in oxygen, fentanyl, and moderate hypocapnia. A thiopental load of up to 20 mg X kg-1 was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained in five cases after thiopental alone, and after thiopental and sodium nitroprusside (SNP) (means +/- s.d.) 1.3 +/- 0.9 microgram X kg-1 X min-1 in the remaining 25 patients. No ECG sign of myocardial ischaemia was observed. One disadvantage was a prolonged recovery period, which in some cases necessitated controlled ventilation for some hours. We conclude that thiopental loading can be used safely as a supplement to neuroanaesthesia for aneurysm surgery.
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D001794:Blood Pressure / Q000187:drug effects; D003243:Consciousness; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007023:Hypotension, Controlled; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009599:Nitroprusside; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D013874:Thiopental; D013997:Time Factors
chemical_list: D009599:Nitroprusside; D013874:Thiopental