Parenteral Manual

Thiopental sodium

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
PENTOTHAL®
Classification: 
General Anesthetic
Original Date: 
August 2005
Revised Date: 
July 2010
Indications: 
  • Induction of anesthesia
  • Adjunct for intubation in head injury patients
  • Control of convulsive states
  • Treatment of elevated intracranial pressure                                                   
Reconstitution and Stability: 
  •  Vials stable at room temperature  
  • To make a 25 mg/mL  (2.5%) solution, add  40 mL of Sterile Water for Injection  to 1000 mg of thiopental
  • Use diluted solutions within 24 hours, discard unused portion                         
  • DO NOT administer if a precipitate is present                    
Compatibility: 

- Solutions Compatible: D5W, NS, 1/2NS

- Additive/buretrol Compatible: hydrocortisone, pentobarbital and propofol for at least 30 minutes; KCl (up to 40 mmol/L)

- Y-site Compatible: fentanyl, heparin, mivacurium, morphine (up to 2 mg/mL), nitrogycerin

- Incompatible: acidic drugs (e.g. atropine, succinylcholine), ringer's solutions and ringer's lactate.  Many medications; better not to mix with other medication.  Run in dedicated line.

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion

YES
Usual dilution: 25 mg/mL
Infusion time: 10-60 minutes                                                                                                   Note:  For RAPID SEQUENCE INTUBATION doses of 5mg/kg have been given over    10 seconds
IV Continuous Infusion

YES
Usual dilution: 25 mg/mL
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:
- Induction of anesthesia:

  • Infants: 5-8 mg/kg IV
  • 1-12 years: 5-6 mg/kg IV

- Maintenance of anesthesia:

  • 1 mg/kg IV PRN

- Seizures:    

  • 2-3 mg/kg/dose IV; repeat PRN

Adult:    
- Induction of anesthesia:

  • >12 years and adults: 3-5 mg/kg IV

- Maintenance of anesthesia:

  • 25-100 mg IV PRN

- Seizures:    

  • 75-250 mg/dose IV, repeat PRN
Potential hazards of parenteral administration: 
  • Thrombophlebitis with concentrated solutions                           
  • Extravasation may cause tissue necrosis
  • Respiratory depression
  • Myocardial depression
  • Hypersensitivity reactions
  • Idiosyncratic reactions to barbiturates
Notes: 
  • Monitor respiratory rate, heart rate, blood pressure
  • Caution in patients with respiratory depression, cardiac disease, hypotension, hepatic or renal dysfunction 
  • Caution with other CNS depressants.  Potentiation of respiratory depression may occur
  • Facilities for assisting respiration and administering oxygen necessary
  • Avoid intra-arterial administration
  • Anesthesia effects:
    - Onset: 30-60 seconds
    - Duration: 5-30 minutes
References: 

The information contained on this website is provided for informational purposes only, as a guide to assist physicians, nurses and other healthcare providers in deciding on the appropriate care required for a particular patient. At all times, physicians, nurses and other healthcare providers must exercise their independent clinical judgment, based on their knowledge, training and experience, taking into account the specific facts and circumstances of each patient, when deciding on the appropriate course of investigation and/or treatment to recommend in a particular clinical situation.

CHEO has made every effort to ensure that the information contained on this website is as current and accurate as possible. However, changes can occur due to ongoing research and the constant influx of new information. Where possible, hospitals and healthcare practitioners should verify the information before acting on it.

Reliance on any information in this website is at the user's own risk. CHEO is not responsible or liable for any harm, loss or other consequences from the use or misuse of the information on this website.