Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Recurso digital |
| Sprache: | |
| Veröffentlicht: |
Zenodo
2026
|
| Online-Zugang: | https://doi.org/10.5281/zenodo.20095479 |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| _version_ | 1866902191416016896 |
|---|---|
| author | Indunil Karunaratha |
| author_facet | Indunil Karunaratha |
| contents | <p class="MsoNormal"><span>Methohexital, an ultra-short-acting methylated barbiturate, occupies a distinctive niche in contemporary anesthetic practice. Unlike other induction agents that have fallen into disuse, methohexital retains clinical relevance due to its unique pharmacokinetic profile—exceptionally rapid onset (peak brain concentrations at 30 seconds) and brief duration of action (4–7 minutes)—and its paradoxical ability to lower seizure threshold while prolonging seizure duration, making it the agent of choice for electroconvulsive therapy. This comprehensive review traces methohexital from its molecular mechanism of action—allosteric modulation of the GABA-A receptor increasing chloride channel open duration—through its FDA-approved indications (induction of anesthesia, short surgical procedures, pediatric use via rectal or intramuscular routes) and established off-label uses (electroconvulsive therapy, procedural sedation for cardioversion, neonatal intubation). The article provides evidence-based dosing guidelines across populations, detailed pharmacokinetic principles emphasizing redistribution-dominant offset, and a systematic analysis of adverse effects (respiratory depression, hypotension, excitatory phenomena including hiccups and myoclonus, injection pain, and laryngospasm). Critical safety information is presented, including absolute contraindications (acute intermittent porphyria, barbiturate hypersensitivity), box warnings regarding administration settings and intra-arterial injection, and monitoring standards requiring dedicated personnel. The conclusion emphasizes that methohexital’s safe and effective use depends not on pharmacologic knowledge alone but on coordinated interprofessional teamwork among anesthesiologists, nurse anesthetists, pharmacists, proceduralists, and nursing staff. When this collaborative framework is respected, methohexital remains a valuable, versatile, and safe agent in the anesthesiologist’s armamentarium.</span></p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_20095479 |
| institution | Zenodo |
| language | |
| publishDate | 2026 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Methohexital in Modern Anesthetic Practice: A Comprehensive Review of Pharmacodynamics, Clinical Applications, and Interprofessional Safety Strategies Indunil Karunaratha <p class="MsoNormal"><span>Methohexital, an ultra-short-acting methylated barbiturate, occupies a distinctive niche in contemporary anesthetic practice. Unlike other induction agents that have fallen into disuse, methohexital retains clinical relevance due to its unique pharmacokinetic profile—exceptionally rapid onset (peak brain concentrations at 30 seconds) and brief duration of action (4–7 minutes)—and its paradoxical ability to lower seizure threshold while prolonging seizure duration, making it the agent of choice for electroconvulsive therapy. This comprehensive review traces methohexital from its molecular mechanism of action—allosteric modulation of the GABA-A receptor increasing chloride channel open duration—through its FDA-approved indications (induction of anesthesia, short surgical procedures, pediatric use via rectal or intramuscular routes) and established off-label uses (electroconvulsive therapy, procedural sedation for cardioversion, neonatal intubation). The article provides evidence-based dosing guidelines across populations, detailed pharmacokinetic principles emphasizing redistribution-dominant offset, and a systematic analysis of adverse effects (respiratory depression, hypotension, excitatory phenomena including hiccups and myoclonus, injection pain, and laryngospasm). Critical safety information is presented, including absolute contraindications (acute intermittent porphyria, barbiturate hypersensitivity), box warnings regarding administration settings and intra-arterial injection, and monitoring standards requiring dedicated personnel. The conclusion emphasizes that methohexital’s safe and effective use depends not on pharmacologic knowledge alone but on coordinated interprofessional teamwork among anesthesiologists, nurse anesthetists, pharmacists, proceduralists, and nursing staff. When this collaborative framework is respected, methohexital remains a valuable, versatile, and safe agent in the anesthesiologist’s armamentarium.</span></p> |
| title | Methohexital in Modern Anesthetic Practice: A Comprehensive Review of Pharmacodynamics, Clinical Applications, and Interprofessional Safety Strategies |
| url | https://doi.org/10.5281/zenodo.20095479 |