Barbiturate coma

Barbiturate Coma

A barbiturate coma is a medically induced coma using barbiturates, a class of drugs that act as central nervous system depressants. This procedure is typically used in the treatment of refractory status epilepticus and to reduce intracranial pressure following traumatic brain injury.

History

The use of barbiturates to induce coma was first proposed in the 1950s. The initial purpose was to control seizures in patients with epilepsy. Over time, the application of barbiturate coma has expanded to include the management of increased intracranial pressure.

Procedure

The procedure involves the administration of high doses of barbiturates, typically pentobarbital or thiopental, to achieve a state of deep sedation or coma. The patient's vital signs and neurological status are closely monitored throughout the procedure. The goal is to reduce cerebral metabolic rate and cerebral blood flow, thereby decreasing intracranial pressure.

Risks and Complications

While a barbiturate coma can be life-saving, it is not without risks. Potential complications include hypotension, respiratory depression, and infection due to prolonged intubation. There is also the risk of barbiturate toxicity, which can lead to serious side effects such as cardiac arrest and kidney failure.

Prognosis

The prognosis for patients undergoing a barbiturate coma depends on the underlying condition being treated. In cases of refractory status epilepticus, the procedure can be highly effective in controlling seizures. However, in cases of traumatic brain injury, the effectiveness of a barbiturate coma in improving long-term outcomes is less clear.

See Also

• Barbiturates
• Status epilepticus
• Traumatic brain injury