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Precipitate formed by thiopentone and vecuronium causes pulmonary embolism

  • Takumi Taniguchi
  • Ken Yamamoto
  • Tsutomu Kobayashi
Laboratory Reports
Accepted:

Abstract

Purpose

To examine the effects of a bolus injection of the precipitate formed by thiopentone and vecuronium on the pharmacokinetic behaviour of thiopentone, cardiopulmonary physiology, and lung histology.

Methods

Of 16 female rabbits (2.9 to 3.1 kg), eight were injected with a precipitate formed by a mixture of 5 mg·kg−1 thiopentone and 0.67 mg·kg−1 vecuronium via the external jugular vein. Eight control rabbits were injected with 5 mg·kg−1 thiopentone alone. Plasma thiopentone concentration, systolic arterial pressure and PaO2 were measured for 60 min after injection. Histological changes in the lungs were evaluated at one and 60 min.

Results

Maximum blood thiopentone concentration in the precipitate group was lower than in the control group (12.9 ± 4.5 vs 17.0 ± 1.6 μg·ml,P < 0.05), although the half-life of thiopentone in the precipitate group was longer (32.3 ± 8.5 vs 21.7 ± 8.2 min.P < 0.05) and the area under the time concentration curve was similar between the two groups. However, the mean residence time was 28% longer in the precipitate group than in controls (P < 0.05). The PaO2 was lower in the precipitate group than in controls one minute after injection (431 ± 27 vs 464 ± 18 mmHg,P < 0.05) but not subsequently. Histologically, crystals (30–150 μm in diameter) obstructed small arteries in the lungs at one minute but not at 60 min after injection.

Conclusion

Intravenous injection of precipitate causes pulmonary microembolism, with a small transient decrease in PaO2

Keywords

Bolus Injection Thiopental Thiopentone Vecuronium Systolic Arterial Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Évaluer l’effet de l’injection en bolus du précipité formé par le thiopental et le vécuronium sur la pharmacocinétique du thiopental, sur la physiologie cardio-pulmonaire et sur l’histologie pulmonaire.

Méthodes

D’un groupe de 16 lapins femelles (2,9 à 3, 1 kg), 8 ont reçu IV par la jugulaire externe un précipité composé de 5 mg·kg−1 de thiopental et de 0,67 mg·kg−1 de vécuronium, alors que les 8 témoins n’ont reçu que du thiopental à la dose de 5 mg·kg−1. Durant les 60 minutes suivant l’injection on a mesuré la concentration plasmatique de thiopental, la pression artérielle systolique et la PaO2. Les changements histologiques du poumon ont été évalués à une minute et à 60 min.

Résultats

La concentration sanguine maximale de thiopental était plus basse dans le groupe précipité que dans le groupe témoin (12,9 ± 4,5 vs 17,0 ± 1,6 μg·ml−1,P < 0,05); cependant, la demi-vie du thiopental dans le groupe précipité était plus longue (32,3 ± 8,5 vs 21,7 ± 8,2 min,P < 0,05) et la surface sous la courbe temps/concentration était similaire pour les deux groupes. Cependant le temps de rétention moyen était de 28% plus long dans le groupe précipité (P < 0,05). La PaO2 était plus basse dans le groupe précipité à 1 minute après l’injection (431 ± 27 vs 464 ± 18 mmHg,P < 0,05) mais non par la suite. Histologiquement, des cristaux (30–150 μm de diamètre) obstruaient les petites artères des poumons à 1 minute après l’injection, mais n’étaient plus visibles à 60 min.

Conclusion

L’injection intraveineuse de précipité cause des microembolies pulmonaires avec une baisse transitoire de la PaO2.

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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Takumi Taniguchi
    • 1
  • Ken Yamamoto
    • 1
  • Tsutomu Kobayashi
    • 1
  1. 1.Department of Anesthesiology and Intensive Care Medicine, School of MedicineKanazawa UniversityKanazawaJapan

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