Hexobarbital

It is very soluble in water and alcohol, practically insoluble in ether. Aqueous solutions of hexenal are unstable, easily hydrolyzed, decompose upon sterilization. Solutions are prepared under aseptic conditions on an isotonic sodium chloride solution or in sterile water for injection immediately before use. Solutions can be stored for no more than an hour. Only absolutely transparent solutions are suitable for use.

Hexenal has hypnotic and narcotic effects.

Hexenal is used for intravenous anesthesia. After intravenous administration of an aqueous solution of hexenal, a narcotic effect quickly occurs, which continues after a single dose of about 30 minutes.

In blood plasma, the water-soluble form of the drug quickly turns into a non-ionized lipophilic form, which easily penetrates the blood-brain barrier.

Due to the inhibitory effect on the respiratory and vasomotor centers, hexenal is not usually used for prolonged intravenous anesthesia, it is used mainly for induction anesthesia in combination with nitrous oxide, fluorotane, ether or other means used for basic anesthesia.

As an independent remedy for anesthesia, hexenal is used mainly for short-term extra-cavity operations (lasting no more than 15-20 minutes) and for endoscopy. Hexenal anesthesia may be combined with local anesthesia.

Hexenal is administered intravenously slowly, usually at a rate of 1 ml per minute. The toxic effect (respiratory and circulatory depression) increases with an increase in the rate of administration and concentration of a solution of hexenal (and other barbiturates). For anesthesia, a 1-2% solution of hexenal is usually used (in some cases, a 2.5-5% solution). Initially, 1–2 ml is administered, and in the absence of side effects, an additional amount of solution is administered for 30–40 s. The total dose, depending on the type of intervention, the general condition of the patient, etc. is 0.5-0.7 g of the drug (8-10 mg / kg).

In debilitated patients, in patients with cardiovascular diseases and in children, a 1% solution is used.

As a drug that activates less vagal reactions than thiobarbiturates ( thiopenanthal sodium ), hexenal is often used for anesthesia during bronchoscopy. Enter into a vein (within 2-3 minutes) a 1-2% solution at the rate of 400-600 mg.

The highest single (also daily) dose of hexenal for adults in a vein is 1 g.

Before anesthesia with hexenal, the patient is administered atropine (or metacin) to prevent side effects associated with excitation of the vagus nerve.

To stop mental arousal, hexenal is injected into a vein: from 2 to 10 ml of a 5% or 10% solution, depending on the patient's condition. In acute alcoholic psychoses (and other acute mental disorders), the introduction of hexenal (7-10 ml of a 10% solution intravenously) is recommended to be supplemented with intramuscular administration of chlorpromazine (4-5 ml of a 2.5% solution).

Hexenal anesthesia is not recommended for cesarean section, since the drug passes through the placental barrier and can cause fetal asphyxiation.

With complications associated with the use of hexenal (respiratory depression and impaired cardiac activity), bemegrid can be used. Calcium chloride is also administered intravenously (up to 10 ml of a 10% solution).

Hexenal is contraindicated in cases of impaired liver function (the drug is mainly metabolized in the liver), as well as for excretory function of the kidneys, for sepsis, inflammatory diseases of the nasopharynx, fever, oxygen deficiency, and pronounced circulatory disorders. With bowel obstruction, anesthesia with hexenal is not recommended, since it inhibits the intestinal motor activity.

White foamy mass. In air, under the influence of carbon dioxide and water vapor decomposes. Hygroscopic.

Storage: List B. In a dry, cool, dark place.