Propofol vs Thiopental

[jsckvc]

Question for any residents or attendings.

How often, if ever are you using IV anesthetic induction drugs other than Propofol (eg. Thiopental) for induction in routine cases? Is it common practice now to use Propofol in all cases that do not have a contraindication to Propofol or an indication for barbiturates? Or, is it just up to the anesthesiologist as to what he is in the “mood for” if no contraindication or indication exists one or the other?

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[jwk]

Question for any residents or attendings.

How often, if ever are you using IV anesthetic induction drugs other than Propofol (eg. Thiopental) for induction in routine cases? Is it common practice now to use Propofol in all cases that do not have a contraindication to Propofol or an indication for barbiturates? Or, is it just up to the anesthesiologist as to what he is in the “mood for” if no contraindication or indication exists one or the other?

Too many advantages to propofol not to use it. I use etomidate perhaps once a month, pentothal just a couple times a year.

 

[urge]

Do they still make thiopental?

That thing was great. Fast on, fast off, no burning on injection, less hypotension. Bad> not good for tiva. Had to keep track of waste.

 

[proman]

Do they still make thiopental?

That thing was great. Fast on, fast off, no burning on injection, less hypotension. Bad> not good for tiva. Had to keep track of waste.

But, you could get a wicked phlebitis from it and while there's no burn, there's that nasty garlic taste. Do you think STP has a faster onset than propofol?

 

[Intensivist]

l was once burned for favouring Thiopental over propofol, but honestly l think it works a lil faster. Can't compare with most of folks here, due to fact that l've seen around 20ish of c/s inductions, but it seems that way. Maybe anaesthetists were subdosing propofol or titrating with smaller doses up to wanted effect, but then again, it wouldn't be RSI by definition.

 

[Mman]

Question for any residents or attendings.

How often, if ever are you using IV anesthetic induction drugs other than Propofol (eg. Thiopental) for induction in routine cases? Is it common practice now to use Propofol in all cases that do not have a contraindication to Propofol or an indication for barbiturates? Or, is it just up to the anesthesiologist as to what he is in the “mood for” if no contraindication or indication exists one or the other?

Propofol the vast majority of the time. I like to mix it up every now and then to keep the CRNAs on their toes. Mask induction, versed/fentanyl/ketamine, thiopental, etc.

 

[pgg]

I used a lot of Brevital last week, but only because the hospital nearly ran out of propofol and I was saving my propofol ration for a couple of MAC cases.

 

[JonnyG]

They are rationing propofol at my hospital. Using etomidate alot. They tend to move too much for my liking. Thiopental is also in short supply so it is restricted to OB.

Now that they stopped making sux "temporarily" I am thinking pretty soon they will just give me a little hammer or a larger boring book to put the patients out and induced