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G-Thiopentone1 gm/vial
Gonoshasthaya Pharmaceuticals Limited
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Thiopental Sodium: Brands, Price & Uses in Bangladesh
Thiopental Sodium is an ultra-short-acting barbiturate used strictly as an anesthetic/critical-care agent, administered only by personnel trained in anesthesia and airway management.
About Thiopental Sodium
Indications of Thiopental Sodium
Thiopental Sodium is an ultra-short-acting barbiturate used strictly as an anesthetic/critical-care agent, administered only by personnel trained in anesthesia and airway management. Its uses can be classified by the strength of supporting evidence as follows:
Established / FDA-Approved Uses
- Induction of general anesthesia, typically as the sole agent for brief procedures or as the induction agent before maintenance with other anesthetics.
- Supplementation of regional anesthesia to produce sedation or light general anesthesia during regional/local anesthetic techniques.
- Component of balanced anesthesia, used together with other anesthetic, analgesic, and neuromuscular-blocking agents as part of a combination anesthetic technique.
Specialist/ICU-Directed Uses
- Control of convulsive states, including status epilepticus, when used under specialist or intensive-care supervision, generally after first-line anticonvulsants have failed.
- Reduction of elevated intracranial pressure in specific neurocritical care contexts (so-called "barbiturate coma"), directed by a specialist/ICU team with continuous monitoring.
Thiopental Sodium is not intended for outpatient, self-administered, or non-specialist use under any circumstance; it must be given only where resuscitation and airway equipment and personnel trained in their use are immediately available.
Dosage & Administration of Thiopental Sodium
Thiopental Sodium must be administered intravenously only, and only by, or under the direct supervision of, personnel trained in the administration of general anesthesia and airway management, with resuscitation equipment, supplemental oxygen, and endotracheal intubation equipment immediately available. Dosing is individualized based on age, body weight, physical status, and the procedure, and is summarized below; it must not be self-administered or given outside a supervised clinical/anesthesia setting.
| Indication / Population | Typical Dosing Guidance |
|---|---|
| Adults - test dose | 25-75 mg (a small test dose) is given first to assess unusual sensitivity before proceeding with the full induction dose. |
| Adults - induction of general anesthesia | Usually 2-4.5 mg/kg intravenously, given slowly (e.g., 50-75 mg increments at 20-40 second intervals) and titrated to the desired depth of anesthesia (onset of sleep); typically 100-250 mg total is sufficient for most healthy adults, but requirements vary widely. |
| Adults - maintenance during anesthesia | Intermittent small increments (e.g., 25-50 mg) as needed, or a dilute continuous intravenous infusion, titrated by the anesthesia provider to the desired anesthetic depth. |
| Convulsive states / status epilepticus (specialist/ICU use) | Individualized intravenous dosing (commonly cited range approximately 75-250 mg, or a titrated infusion) under continuous specialist/ICU and, where possible, EEG monitoring, generally reserved for seizures not controlled by first-line agents. |
| Reduction of intracranial pressure (barbiturate coma, ICU/specialist-directed) | Individualized intermittent boluses or continuous infusion titrated to clinical and, where available, EEG or intracranial pressure monitoring endpoints, under specialist neurocritical care supervision. |
| Pediatric induction | Weight-based intravenous dosing determined by the anesthesia provider; children may require a relatively higher mg/kg dose than adults. Safety and dosing must be individualized by a specialist experienced in pediatric anesthesia. |
| Elderly, debilitated, or hemodynamically unstable patients | Reduced doses are required because of increased sensitivity and slower redistribution/metabolism; titrate cautiously to effect. |
| Hepatic impairment | Use with caution and reduced dosing, as Thiopental Sodium is metabolized hepatically and effect may be prolonged. |
Extravasation or accidental intra-arterial injection is a serious, well-documented risk (see Precautions and Warnings) and requires strict attention to venous access technique. Thiopental Sodium must never be given by any route other than the intravenous route as directed by the anesthesia/critical-care team.
Side Effects of Thiopental Sodium
Thiopental Sodium is administered only in monitored anesthesia/critical-care settings; even so, it carries significant risks of dose-related adverse effects, including:
- Respiratory: respiratory depression, apnea, laryngospasm, and bronchospasm, particularly with rapid injection or in patients with reactive airway disease.
- Cardiovascular: hypotension and myocardial depression, especially in hypovolemic, elderly, or hemodynamically unstable patients; arrhythmias may occur.
- Neurological/recovery-related: prolonged somnolence or delayed recovery, particularly after repeated dosing or infusion due to drug accumulation in fat.
- Injection-site/vascular: pain, venous thrombosis, or tissue damage from extravasation; severe tissue necrosis, arteriospasm, and risk of gangrene if the drug is accidentally injected intra-arterially (a medical emergency requiring immediate specific management).
- Hypersensitivity: rash, and rarely anaphylactoid or anaphylactic reactions.
- Rare: hemolytic anemia and peripheral nerve palsy (usually related to positioning during prolonged unconsciousness) have been reported.
Contraindications of Thiopental Sodium
Thiopental Sodium is contraindicated in patients with:
- Known hypersensitivity to Thiopental Sodium, other barbiturates, or any component of the formulation.
- Porphyria (e.g., acute intermittent porphyria, variegate porphyria) - barbiturates, including Thiopental Sodium, can precipitate a life-threatening porphyric crisis and must not be given to patients with this condition.
- Absence of suitable veins for intravenous administration (since Thiopental Sodium must be given only by the intravenous route).
- Status asthmaticus (severe, uncontrolled bronchospasm), given the risk of provoking severe bronchospasm/laryngospasm in this setting.
Frequently Asked Questions about Thiopental Sodium
What is Thiopental Sodium used for?
Thiopental Sodium is an ultra-short-acting barbiturate used mainly for induction of general anesthesia before surgery, as a supplement to regional anesthesia, and, in hospital/ICU settings under specialist supervision, for controlling certain seizures (status epilepticus) and for reducing severely elevated intracranial pressure. See Indications for details.
Can Thiopental Sodium be given at home or by a patient themselves?
No. Thiopental Sodium must be given only by, or under the direct supervision of, personnel trained in anesthesia and airway management, in a setting with resuscitation equipment immediately available, because of the risk of serious respiratory and cardiovascular depression. It is never intended for self-administration or outpatient/home use.
Is Thiopental Sodium safe to use during pregnancy?
Thiopental Sodium crosses the placenta and is used for anesthesia induction in pregnant patients (including for cesarean section) only when surgery is clearly needed, under the direct supervision of an anesthesia specialist who manages the dose and timing to limit effects on the newborn. It should never be used outside such specialist-directed care. See Pregnancy and Lactation for more detail.
What are the main risks of Thiopental Sodium?
The main risks of Thiopental Sodium include respiratory depression and apnea, laryngospasm or bronchospasm, low blood pressure and myocardial depression, and, if the injection leaks outside the vein or accidentally enters an artery, severe local tissue damage or gangrene. This is why Thiopental Sodium is given only by trained anesthesia personnel with monitoring and resuscitation equipment available. See Side Effects for the full list.
Who should not receive Thiopental Sodium?
Thiopental Sodium must not be given to patients with known hypersensitivity to barbiturates, patients with porphyria (a condition in which barbiturates can trigger a life-threatening crisis), patients without suitable veins for intravenous injection, or patients with status asthmaticus (severe, uncontrolled bronchospasm). See Contraindications for the complete list.
What happens if too much Thiopental Sodium is given?
Excessive dosing of Thiopental Sodium can cause profound unconsciousness, stopped or severely depressed breathing (apnea), and dangerously low blood pressure or cardiovascular collapse. Because Thiopental Sodium is only given in monitored medical settings, such events are managed immediately by the treating team with airway support, ventilation, and circulatory support; there is no specific antidote. See Overdose Effects.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.