Althesin infusions for maintenance of anaesthesia

Towler, C. M.; Garrett, Rebecca; Sear, J. W.

doi:10.1111/j.1365-2044.1982.tb01154.x

Cited by 22 publications

(3 citation statements)

References 42 publications

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“…While thiopentone has been used for this purpose, its pharmacokinetic properties leave much to be desired, having an elimination half-life which is appreciably longer than that of methohexitone (Hudson et al 1982), which would seem to be the barbiturate of choice. The use of Althesin has been widely recommended for this purpose (Savege 1979, Towler et al 1982, although there may be a hazard from the effects of large doses of Cremophor: furthermore this drug could not safely be given to patients who have previously had a Cremophor-containing anaesthetic or who have a history of atopy or allergy (Clarke et al 1975, Fisher & More 1981.…”

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confidence: 99%

Clinical Aspects of Total Intravenous Anaesthesia: Discussion Paper

Dundee

McMurray

1984

J R Soc Med

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One may wish to use total intravenous anaesthesia to reduce the pollution hazard in the operating theatre, to avoid repeating the administration of potentially toxic drugs, or for specific indications where the inhalational technique is unsuitable. It may eventually become the method of choice where sophisticated modern equipment is not available, but as yet we have not progressed sufficiently with our understanding or our investigation of the technique to recommend it as a routine outside major centres. To most anaesthetists total intravenous anaesthesia means the administration of barbiturates or other induction agents throughout the period of anaesthesia, supplemented by a myoneural blocking drug and possibly with a potent narcotic and combining these with the continuous use of nitrous oxide/oxygen. Our knowledge of potent narcotics has increased dramatically in the last few years and, while we include high doses of analgesics under this heading, it is not always appreciated that nitrous oxide can be dispensed with while the patient is breathing oxygen-enriched air. This simplifies the method. For more than three decades anaesthetists have been using balanced anaesthesia, based on a drug which will induce sleep, one which will produce muscular paralysis and an analgesic or other means of suppressing reflex response to the operation. This has certainly achieved worldwide acceptance and there is no reason why the same principles should not apply to total intravenous anaesthesia.

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confidence: 99%

Clinical Aspects of Total Intravenous Anaesthesia: Discussion Paper

Dundee

McMurray

1984

J R Soc Med

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“…In the spontaneously breathing patient, infusion rates up to 4 times the maintenance rate led to only minor increases in Paco 2 . 5 Althesin also had little influence on renal or hepatic function 6,7 and appeared to be a useful anesthetic for the management of patients susceptible to malignant hyperthermia. However, it was considered unsafe in patients with acute porphyria.…”

Section: Alfaxalonementioning

confidence: 97%

Another Steroid Hypnotic

Hollmann

Sear

2015

Anesthesia &Amp; Analgesia

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“…This made it very popular in neurosurgical intensive care and for the management of head injuries. Fears developed about hypersensitivity reactions, the incidence of which has been variously estimated from 1:900 (32) to 1:10,000 (33), and resulted in the manufacturers withdrawing the agent in 1984. Concerns also developed about the hepatotoxic effects of its solubilizing agent, Cremaphor EL, which accumulated during infusion (34).…”

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confidence: 99%