High-dose thiopental was administered in 8 children with uncontrollable seizures or hypoxic encephalopathy (group A) and 7 full-term neonates with neonatal asphyxia (group B), All of them were submitted to artificial hyperventilation to maintain pCO(2) near 3.5 kPa. Rectal temperature was kept at about 35 °C. Thiopental was infused with a rate of 2-4 mg^-1-kg^-1, with treatment lasting 32-192 h for group A (mean 103 h), and 36-48 h for group B (mean 38.5 h). Plasma concentration-time data were analysed pharmacokinetically. Thiopental elimination half-life was 14.5 h (group A) and 20.9 h (group B). The clearance of thiopental was 0.27 liters × h^-1 -kg"1 (group A) and 0.32 liters × h^-1 × kg-1 (group B). The volume of distribution at steady-state was 5.41 liters-kg 1(group A) and 8.26 liters-kg-' (group B). These results show that high-dose thiopental pharmacokinetics is not very different for full-term newborns, children and adults. Elimination half-life and volume of distribution are changed when compared to single-dose studies, while clearance is only slightly modified. The time for disappearance of thiopental from blood is also very long (2 to 5 days). These pharmacokinetic characteristics would be worthy of consideration in cases where there may be prolonged use of thiopental,considering the risk of accumulation and toxicity.

Keywords:
Thiopental, High-dose thiopental, Cerebral resuscitation, high-dose thiopental
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1987
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