Composition
Inj 500 mg: Thiopentone sodium 500 mg; powder in vials.
Indications & Dosage
Induction of anaesthesia, Anaesthesia of short duration: BY SLOW IV INJ: Adult: Initially 100-150 mg, to be administered over 10-15 seconds usually as a 2.5% (25 mg/ml) solution, followed by 100-150 mg after 0.5-1 minute if required, debilitated patients or adults over 65 years may require a lower dose or increased administration time, alternatively initially up to 4 mg/kg (max. per dose 500 mg). Children 1 month-18 yrs: Initially up to 4 mg/kg then 1 mg/kg repeated as necessary (max total dose 7 mg/kg). Reduction of raised intracranial pressure if ventilation controlled: BY SLOW IV INJ: Adult: 1.5-3 mg/kg, repeated if necessary. Status epilepticus when other measures fail: BY SLOW IV INJ: Adult: 75-125 mg for 1 dose, to be administered as a 2.5% (25 mg/ml) solution. Children 1 month-18 yrs: Initially up to 4 mg/kg by slow IV injection, then up to 8 mg/kg/hr by continuous IV INF, adjusted according to response.
Administration
Administered by slow IV infusion only, reconstituted solution is highly alkaline-extravasation causes tissue necrosis and severe pain; avoid intra-arterial injection. For intermittent IV administration, the continuous used range between 2% and 5% in SWFI, dextrose 5%, NaCI 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%, NaCI 0.9%, or a pH 7, 4 combined electrolyte solution are used. Do not use sterile water for injection to prepare thiopental sodium solutions less than 2% because such solutions would be very hypotonic and would cause haemolysis.
Stability
Reconstitute in SWFI or NaCI 0.9%, store under refrigerator and tightly sealed for 7 days. Store at room temperature for 3 days
Contraindications
Acute porphyria; myotonic dystrophy.
Precautions
Acute circulatory failure (shock), hepatic impairment, severe renal impairment, cardiovascular disease, elderly, fixed cardiac output, hypovolaemia
Interactions
See literature, as per practitioners advice.
Pregnancy
Caution; may depress neonatal respiration when used during delivery
Lactation
Caution advised
Side Effects
Arrhythmias, headache, myocardial depression, hypotension, laryngeal spasm, rash, sneezing, cough, hypersensitivity reactions