Abstract
Prompted by the extensive experience of Bruce et al. W and Marshall et al. (14), we induced barbiturate coma in 27 brain trauma patients with intracranial pressure (ICP) raised to more than 25 torr for more than 15 minutes, and unresponsive to dexamethasone, mannitol, furosemide and moderate hyperventilation, as in a boy exhibiting Lundberg waves and pronounced ICP reactions to nursing (Fig. 1).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Altenburg BM, Michenfelder JD, Theye RA (1969) Acute tolerance to thiopental in canine cerebral oxygen consumption studies. Anesthesiology 31:443–448
Astrup J, Skovsted P, Gjerris F, Sørensen HR (1981) Increase in extracellular potassium in the brain during circulatory arrest: effects of hypothermia, lidocaine and thiopental. Anesthesiology 55:256–262
Becker KE (1978) Plasma levels of thiopental necessary for anesthesia. Anesthesiology 49:192–196
Bruce DA, Raphaely RA, Swerdlow D, Schut L (1980) The effectiveness of iatrogenic barbiturate coma in controlling increased ICP in 61 children. In: Shulman K, Marmarou A, Miller JD, Becker DP, Hochwald GM, Brock M. Eds. Intracranial pressure. Springer, Berlin Heidelberg New York, pp 630–632
De los Reyes RA, Babcock RA, Malik GM, Diaz FG, Ausman JI (1981) Silent duodenal perforation: A difficult diagnosis in iatrogenic barbiturate coma. Crit Care Med 9:104–105
Frost E AM, Tabaddor K, Kim BY (1981) Induced barbiturate coma: results in 20 cases (Abstr.). Anesth Analg 60:247
Gennarelli TA, Spielman GM, Langfitt TW, Gildenberg PL, Harrington T, Jane JA, Marshall LF, Miller JD, Pitts LH (1982) Influence of the type of intracranial lesion on outcome from severe head injury. A multicenter study using a new classification system. J Neurosurg 56:26–32
Gisvold SE, Safar P, Hendricks H, Alexander H (1981) Thiopental treatment after global brain ischemia in monkeys. Anesthesiology 55:A97
Gobiet W (1977) Intensivtherapie nach Schädel-Hirn-Trauma. Springer, Berlin Heidelberg, New York, p 48
Hasselström L, Kristoffersen MB (1979) Hepatitis following thiopentone. A case report. Br J Anaesth 51:801–804
Jennett B, Bond MR (1975) Assessment of outcome after severe brain damage. Lancet 1:480–484
Jennett B, Teasdale G, Braakman R, Minderhoud H, Heiden J, Kurze T (1979) Prognosis of patients with severe head injury. Neurosurgery 4:283–289
Lauven PM Personal communication. Department of Anesthesiology, University of Bonn, FRG
Marshall LF, Smith RW, Shapiro HM (1979) The outcome with aggressive treatment in severe head injuries. Part II Acute and chronic barbiturate administration in the management of head injury. J Neurosurg 50:26–30
Michenf Elder JD (1974) The interdependency of cerebral functional and metabolic effects following massive doses of thiopental in the dog. Anesthesiology 41:231–236
Nilsson B, Nordström CH (1977) Rate of cerebral energy consumption in concussive head injury in the rat. J Neurosurg 47:274–281
Overgaard J, Mosdal C, Tweed WA (1981) Cerebral circulation after head injury. Part 3: Does reduced regional cerebral blood flow determine recovery of brain function after blunt head injury? J Neurosurg 55:63–74
Pagliaro L, Campesi G, Aguglia F (1969) Barbiturate jaundice. Report of a case due to a barbital-containing drug with positive rechallenge to phénobarbital. Gastroenterology 56:938–943
Steen PA, Michenf Elder JD (1980) Mechanisms of barbiturate protection. Anesthesiology 53:183–185
Todd MM, Chadwick HS, Shapiro HM, Dunlop BJ, Marshall LF, Dueck R (1982) The neurologic effects of thiopental therapy following experimental cardiac arrest in cats. Anesthesiology 57:76–86
Toner W, Howard PJ, McGowan WAW, Dundee JW (1980) Another look at acute tolerance to thiopentone. Br J Anaesth 52:1005–1008
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1983 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Wiedemann, K. (1983). Thiopentone in the Treatment of Severe Head Injury: Is Raised Intracranial Pressure the Sole Indication for Its Use?. In: Wiedemann, K., Hoyer, S. (eds) Brain Protection. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69175-1_18
Download citation
DOI: https://doi.org/10.1007/978-3-642-69175-1_18
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-69177-5
Online ISBN: 978-3-642-69175-1
eBook Packages: Springer Book Archive