Abstract
One hundred and fifteen unpremedicated children, induced with thiamylal, a short-acting thiobarbiturate, administered rectally (25 mg·kg-1 body wt) or intravenously (6 mg·kg-1) had arterial pH of 7.36 ± 0.03 and PaCO2 of 40 · 4 mmHg. In 22 children over two years of age, the use of fentanyl (1.2 · 0.7 μg·kg-1) in addition to the thiamylal did not change blood gas data compared to those children over two years receiving only barbiturates (pH 7.36 vs 7.36, PaCO2 41 vs 40 mmHg). Children with cyanotic congenital heart disease showed similar pH andPaCO2 to acyanotic childrenfollowing administration of the short-acting barbiturate. Thiobarbiturates, given in a titrated fashion under direct observation, have clinically small effects on arterial pH and PaCO2 in paediatric patients.
Résumé
Cent-quinze enfants non prémédiqués induits avec du thiamylal, un thiobarbilurique à courte action, administré par voie rectale (25 mg·kg-1) ou par voie intraveineuse (6 mg·kg-1) avait un pH artériel de 7.36 ± 0.03 et une PaCO2 à 40 ± 4 mmHg. Chez 22 enfants âgés de plus que deux ans, ľutilisation du fentanyl (1.2 ± 0.7 μg·kg-1) en plus du thiamylal n’a pas altéré les données de la gazométrie comparativement aux enfants ayant reçu uniquement les barbituriques (pH 7.36 vs 7.36, PaCO2 41 versus 40 mmHg). Les enfants atteints ďune maladie cardiaque congénitale cyanogène ont démontré des pH et des PaCO2 identique aux enfants acyanotiques après administration du barbiturique à courte action. Des thiobarbituriques, administrés sous surveillance et titrés provoquent de faibles effets cliniques sur le pH artériel et la PaCO2 chez les patients pédiatriques.
Article PDF
Similar content being viewed by others
References
Drolet H, Boisvert M. Clinical value of rectal thiopentone in paediatric anaesthesia. Can Anaesth Soc J 1965; 12: 154–60.
Goresky GV, Steward DJ. Rectal methohexitone for induction of anaesthesia in children. Can Anaesth Soc J 1979; 26: 213–5.
Liu L, Goudsouzian N, Liu P. Rectal methohexital premedication in children, a dose comparison study. Anesthesiology 1980; 53: 343–5.
Swanson EE. Sodium 5-allyl-5-(l-methylbutyl)-2-thiobarbiturate, a short acting anaesthetic. J Pharm Pharmacol 1951; 3: 112–6.
Tovel RM, Anderson CC, Sadove MS et al. A comparative clinical and statistical study of thiopental and thiamylal in human anesthesia. Anesthesiology 1955; 16: 910–26.
Barron DW, Dundee JW, Gilmore WR et al. Clinical studies of induction agents XVI: a comparison of thiopentone, buthalitone, hexobarbitone and thiamylal as induction agents. Br J Anaesth 1966; 38: 802–11,
Albert MS, Winters RW. Acid-base equilibrium of blood in normal infants. Pediatrics 1966; 37: 728–32.
Koch G, Wendel H. Adjustment of arterial blood gases and acid base balance in the normal newborn infant during the first week of life. Biol Neonate 1968; 12: 136–61.
Levison H, Featherby EA, Weng T-R. Arterial blood gases, alveolar-arterial oxygen difference, and physiologic dead space in children and young adults. Am Rev Respir Dis 1970; 101: 972–4.
Siggaard-Anderson O. The Acid-Base Status of the Blood. 2nd ed. Baltimore: Williams and Wilkins, 1964.
Nunn JF. Applied Respiratory Physiology. 2nd ed. London, Boston: Butterworths, 1977, p. 33, 51.
Eckenhoff JE, Helrich M. The effect of narcotics, thiopental and nitrous oxide upon respiration and respiratory response to hypercapnia. Anesthesiology 1958; 19: 240–53.
Knill RL, Bright S, Manninen P. Hypoxic ventilatory response during thiopentone sedation and anaesthesia in man. Can Anaesth Soc J 1978; 25: 366–72.
Lister G,Talner NS. Management of respiratory failure of cardiac origin.In. Gregory G (ed): Respiratory failure in the child, 1981, Churchill Livingstone, p. 76-80.
Berger AJ, Mitchell RA, Severinghaus JW. Regulation of respiration. N Engl J Med 1977; 297: 92–7.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lynn, A.M., Morray, J.P. & Furman, E.B. Short-acting barbiturate sedation: effect on arterial pH and PaCO2 in children. Can J Anaesth 35, 76–79 (1988). https://doi.org/10.1007/BF03010550
Issue Date:
DOI: https://doi.org/10.1007/BF03010550