SODIUM THIOSULPHATE DECREASES BLOOD CYANIDE CONCENTRATIONS AFTER THE INFUSION OF SODIUM NITROPRUSSIDE

• Published in: British journal of anaesthesia : BJA Vol. 59; no. 5; pp. 531 - 535
• Main Authors: COLE, P.V., VESEY, C.J.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.1987; Oxford University Press
• Subjects: Adult; Anesthetics. Neuromuscular blocking agents; Antidotes - therapeutic use; Biological and medical sciences; Cyanides - blood; Erythrocytes - analysis; Female; Ferricyanides - antagonists & inhibitors; Humans; Hypotension, Controlled; Male; Medical sciences; Neuropharmacology; Nitroprusside - antagonists & inhibitors; Pharmacology. Drug treatments; Thiocyanates - blood; Thiosulfates - therapeutic use; Human; Induced arterial hypotension; General anesthesia; Metabolite
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/59.5.531

Plasma and red cell cyanide, and plasma thiocyanate, concentrations were measured in 30 patients undergoing elective nitro-prusside-induced hypotension. One randomly selected group (n = 15), who received 0.21–0.70 mg kg−1 over periods of 50– 160 min, were given a bolus of sodium thio-sulphate 10.6-38.5 mg kg−1 immediately on cessation of the nitroprusside administration. The other group, who received infusions of 0.11–0.85 mg kg–1 for periods of 59—197 min, received no antidote. Cyanide concentrations, expressed as a percentage of the immediate post-infusion values, were significantly lower in the treated group in all subsequent blood samples (at 10, 30 and 60 min; plasma cyanide P < 0.05; red cell cyanide P < 0.001). Improved cyanide metabolism was further demonstrated by a sharp increase in mean plasma thiocyanate concentration (P < 0.05) in the group receiving the antidote.