[60 years thiopental]

In 1994, thiopentone has been in clinical use as an induction agent for 60 years. For this reason, a literature review is given dealing with its chemical properties and pharmacokinetics with special regard to plasma protein binding, recommended speed of injection, diaplacentar transfer to the foetus in Caesarean section and the transfer to breast milk. The pharmacodynamics of thiopentone are reviewed with emphasis on the effects on the CNS, the cardiovascular system, the respiratory system, renal function, liver and the effect in porphyria. Its side effects such as local reactions and release of histamine are also reviewed. The clinical importance of thiopentone in anaesthesia induction and the present state of cerebral protection are discussed, as well as the results of controlled trials comparing thiopentone to other induction drugs. Thiopentone has the main disadvantage of a slow elimination resulting in minor CNS depression, which seems of very limited clinical importance. In most respects thiopentone seems to be comparable to its younger competitors.