Tehran University Medical Journal

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Background: Propofol and Thiopental are intravenous anesthetics having relatively different hemodynamic influences and adverse effects. In addition, there is significant pain on intravenous injection of propofol. This study was performed to examine the effects of Propofol-Thiopental admixture on hemodynamic variables, pain on injection and hypnotic dose at the time of induction of general anesthesia.
Methods: One hundred and twenty-five ASA I or II patients scheduled for elective surgery were randomized into four groups for induction of anesthesia in a double-blinded manner. With an original concentration of Propofol of 1% and that of Thiopental of 2.5%, we used these drugs in each group as follows: group P100: Propofol alone group P75: ¾ Propofol and ¼ thiopental (volume/volume) group P50: ½ Propofol and ½ thiopental group T100: Thiopental alone (control group). Hemodynamic variables (before and after induction), score of pain on injection and hypnotic doses were recorded and statistically analyzed.
Results: Admixture of Thiopental and Propofol reduces the injection pain of Propofol, as admixtures P75 and P50 were significantly less painful on injection than P100. Induction of hypnosis was significantly more rapid in group T100 than in groups P100 and P75. The interaction of Propofol and Thiopental with regard to their hypnotic effect is additive. Therefore a reduction in the dose of one was compensated by proportional increase in the dose of the other drug for a hypnotic effect. After anesthesia induction, systolic and diastolic blood pressures were significantly lower in group P100 than in groups P75, P50 and T100. The heart rate after laryngoscopy and tracheal intubation was significantly lower in group P100 than in groups P50 and T100.
Conclusion: Propofol-Thiopental admixture causes minimal pain on injection for intravenous induction of anesthesia with modified hemodynamic effects in comparison with each drug when used separately.