Posology Using of thiopental is reserved only for health care personnel trained in anaesthesiology. A person qualified in the use of anesthetics should be constantly available during the administration of the medicinal product. After continuous administration of thiopental the effect duration is prolonged, personnel qualified in the use of anesthetics should be constantly available during the administration of the medicinal product.
A normal adult dose for induction of anaesthesia is 4-6 mg/kg body weight, but the individual response to the drug is so varied that there can be no fixed dosage. The medicinal product should be titrated against patient requirements as governed by age, sex, body weight and the patient’s general condition.
The dose should usually be reduced and carefully titrated in patients with a poor general condition. Younger patients require relatively larger doses than middle-aged and elderly persons; the latter metabolize the drug more slowly. Pre-puberty requirements are the same for both sexes, but adult females require less than adult males.
Dose is usually proportional to body weight and obese patients require a larger dose than relatively lean persons of the same weight. 5% solution) to assess tolerance or unusual sensitivity to thiopental and pause to observe patient reaction for at least 60 seconds.
If unexpectedly deep anesthesia develops or if respiratory depression occurs, consider these possibilities: 1. The patient may be unusually sensitive to thiopental. 2. The solution may be more concentrated than had been assumed. 3. The patient may have received too much premedication.
). Use in Anesthesia Moderately slow induction can usually be accomplished in a healthy female or male adult weighing 60-80 kg by injection of 50 to 75 mg of thiopental at intervals of 20 to 40 seconds, depending on the reaction of the patient.
Once anesthesia is established, additional injections of 25 to 50 mg can be given whenever the patient moves. Slow injection is recommended to minimize respiratory depression and the possibility of overdosage. The smallest dose consistent with attaining the surgical objective is the desired goal.
Momentary apnea following each injection is typical, and progressive decrease in the amplitude of respiration appears with increasing dosage. Pulse remains normal or increases slightly and returns to normal. Muscles usually relax about 30 seconds after unconsciousness is attained, but this may be masked if a skeletal muscle relaxant is used.
The tone of jaw muscles is a fairly reliable index. The pupils may dilate but later contract. Sensitivity to light is not usually lost until a level of anesthesia deep enough to permit surgery is attained. Nystagmus and divergent strabismus are characteristic during early stages, but at the level of surgical anesthesia, the eyes are central and fixed.
Corneal and conjunctival reflexes disappear during surgical anesthesia. 6). 6. With continuous infusion, the depth of anesthesia is controlled by adjusting the rate of infusion. Paediatric population The doses are recommended for healthy paediatric population, and doses may have to be adjusted depending on for example concomitant illness, preanesthesia.
Newborns IV 3 to 4 mg/kg then 1 mg/kg as needed Infants IV 5 to 8 mg/kg then 1 mg/kg as needed. Children IV 5 to 6 mg/kg then 1 mg/kg as needed. The suggested paediatric dosage categories are only indicative of required doses. Actual dosing must be individualized and titrated to effect based on age, maturity and the general condition of the paediatric patient.
5% w/v solution) should be given as soon as possible after the convulsion begins. Further doses may be required to control convulsions following the use of a local anaesthetic. Other regimens, such as the use of intravenous or rectal diazepam, may be used to control convulsive states.
Paediatric population Intravenously 2 mg/kg initially and then individually titrated until satisfactory clinical effect has been established. A maximum dose of 5 mg/kg/h should not be exceeded. 5 to 3 mg/kg of bodyweight may be given to reduce elevations of intracranial pressure if controlled ventilation is provided.
Paediatric population The safety of thiopental in paediatric populations to treat raised intracranial pressure has not yet been established. 4). 4). Method of administration This medicinal product must only be administered by the intravenous route.
4). 6. Infusion should only be given through a central venous catheter.