Thiopental: Advantages And Disadvantages In Medical Use

Thiopental is an anesthetic. It is a barbiturate, a drug that acts on the central nervous system by blocking its action. Because of this effect, barbiturates are often used as sedatives and analgesics.

Today, thiopental is used less in medical treatment, and drugs with fewer side effects are preferred instead.

Since taking this medicine, many patients have described feeling slow and a little confused after waking up from anesthesia. In fact, almost everyone has compared feeling like they are too much in the morning after drinking alcohol, i.e. in a hangover.

It should also be noted that this is a very short-lived active substance. Some of the experiments performed by the researchers sought to determine if thiopental could cause the patient to fall into hypnosis. Eventually, however, the scientific and nursing community came to the conclusion that the drug did not work effectively for such a purpose. In the treatment of the patient, the substance is used only as a short-term anesthetic and its effect lasts for a few minutes.

Active ingredients of thiopental

Thiopental, like other barbiturates, is a substance that binds to GABA receptors. Although the subclass of the receptor is different, the active factor in thiopental is the same as in other relaxants, such as benzodiazepines.

When a substance binds to a receptor, the result is a combination that regulates the transmission of information to the human central nervous system.

Thiopental acts as an anesthetic and sedative precisely because of this regulation. In addition, it appears to prevent seizures, because if a person has seizures or a seizure, it prevents them from being transmitted to the neurotransmitter GABA.

During this calming effect, the person goes into a calm state and the metabolism of the brain decreases. Because the need for nutrients is very low in this condition, blood circulation is also reduced. Therefore, thiopental also acts as an anti-circulatory treatment, thus lowering the pressure inside the human skull.

Use of thiopental

In general, in order to determine whether a physician is using thiopental in the treatment of a patient, the route of administration should be considered.

Often, thiopental is administered through a tracheal intubation tube or by inserting plastic tubes into the trachea orally.

What is most interesting about the use of thiopental is that when the drug is given in very low doses, it causes the pharyngeal reflex to stop. Therefore, thiopental is helpful in treating oral, throat, or respiratory problems, and is especially useful in emergencies where the patient is not breathing properly.

The same applies to situations where the patient has some type of oral injury and blood or foreign objects (remnants, teeth, etc.) make it difficult to insert the tube. In this case, the area is not seen properly, and in these cases inhalation of the substance is usually required to induce anesthesia.

Doctors and specialists also use thiopental as an anesthetic when the effect is needed for a short time.

As already mentioned, thiopental is used less and less in medicine today. Instead, other anesthetics are usually chosen. There are clear reasons for this: thiopental is an anesthetic and sedative, but it does not act as an analgesic. So it just calms the patient.

However, there are some situations where thiopental may be a good choice.  For example, it is sometimes used by doctors in neurosurgery in patients with an injury or high intracranial blood pressure.

In addition, doctors and nurses give it to patients in psychiatric care who have seizures and who do not respond properly to other medications.

Possible side effects

In the following, we describe the various factors and conditions that prevent the use of thiopental:

• Hypersensitivity to barbiturates: This means that when a patient receives a small dose of that medicine, the effect is very strong and long-lasting. Unfortunately, anesthesia can cause low respiratory rate, and therefore should definitely be considered if the patient is sensitive to barbiturates.

• A patient should never receive this medicine if they have taken other products that paralyze the central nervous system – especially alcohol.  These work in a very similar way, so they significantly increase the effects of thiopental.
• Pregnancy and breast-feeding: Thiopental is transmitted to the fetus, so it still causes paralysis of the nervous system.
• When a patient has a job that requires handling hazardous materials or using vehicles. Of course, this should always be kept in mind, as it is a sedative that reduces a person’s ability to focus properly on their work.

Administration of the drug to the patient

In general, physicians almost always administer thiopental intravenously to a patient. However, it can be administered through tubes to provide anesthesia through inhalation.

The dosage varies, but is usually 2-4 mg per kilogram body weight. Nevertheless, dosing is done taking into account that this recommendation varies and each person has a different sensitivity to thiopental. Therefore, this substance should always be given as little as possible first and then the dosage should be increased gradually.

Generally, thiopental affects the patient one minute after administration. However, the effect lasts only a few minutes if the patient’s condition is not stabilized by giving an additional maintenance dose.