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Minimum induction dose (MID) of thiopentone in Pakistani patients
F A Khan1, N U Saqib, T H Bhatti
1Department of Anesthesiology, Aga Khan University Hospital & Medical College, Karachi.
Insights
This study determined the optimal thiopentone induction dose for Pakistani patients across different age groups. Pakistani adults require lower thiopentone doses than British populations, with specific recommendations for males and females.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Thiopentone is a widely used anesthetic induction agent.
- Optimal dosing is crucial for patient safety and efficacy.
- Variations in anesthetic requirements exist across different populations.
Purpose of the Study:
- To determine the minimum induction dose of thiopentone for abolishing the eyelash reflex in Pakistani patients.
- To investigate the influence of age, sex, ASA classification, and premedication on thiopentone dosage.
- To compare Pakistani dosage requirements with established British recommendations.
Main Methods:
- A study involving 505 Pakistani patients, categorized into three age groups: <16, 16-60, and >60 years.
- Determination of minimum induction dose for thiopentone in each subgroup.
- Analysis of factors including sex, ASA classification, and premedication effects on dosage.
Main Results:
- The mean induction dose in adult patients (16-60 years) was 215.8 ± 66 mg (3.48 mg/kg).
- Significant sex-based differences in thiopentone dose were observed in adults and the elderly, but not in children.
- Thiopentone dosage decreased with advancing age, and ASA I/II patients required less than ASA III.
- Premedicated patients required lower doses compared to non-premedicated individuals.
Conclusions:
- Pakistani patients generally require lower thiopentone induction doses than the British population.
- Recommended doses for adult Pakistani males are 3.5 mg/kg and for adult females are 3.3 mg/kg.
- Age, sex, and ASA classification significantly impact thiopentone requirements in the Pakistani population.
Abstract:
The thiopentone dose needed for abolition of eyelash reflex was studied in 505 Pakistani patients who were divided in three subgroups, i.e., age less than 16 years, between 16 and 60 years, and over 60 years. The minimum induction dose for thiopentone was then determined in the three groups and the effect of sex, ASA classification, premedication and advancing age were seen. The minimum induction dose in the adult patients (16-60) was 215.8 +/- 66 mgs (3.48 mgs/kg). Both the adult groups and the elderly showed a statistical difference in the dose required by the males and females, but this difference was not seen in children. Thiopentone dose also showed a steady decline as the age progressed. A statistical correlation existed between ASA I and II patients compared to ASA III who required less thiopentone. The premedicated patients required less thiopentone compared to those who did not receive a premedication. Our patients required a lesser dosage for abolition of eyelash reflex than the figures recommended for British population. We recommend a dose of 3.5 mg/kg for adult Pakistani males and 3.3 mg/kg for adult females.