Is Thiopental safe while breastfeeding?

Effects on the breastfed infant

Relevant published information was not found as of the revision date.

Effects on milk supply

A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants.[ 6 ]

Levels in milk

Maternal Levels. A woman was given a continuous infusion of thiopental sodium. During the infusion and 25 minutes after its initiation and about 800 mg had been given, a milk level of 7.5 mg/L was measured. A second milk sample taken 14 minutes after completion of the infusion of a total of 1125 mg contained 20 mg/L.[ 3 ] The accuracy and specificity of this old analytic technique were not well defined. Four women who received intravenous thiopental for anesthesia induction prior to cesarean section had breastmilk samples taken on days 1 and 2 postpartum. Exact doses were not specified, but were in the range of 200 to 500 mg. The average milk concentrations were 1.96 mg/L on day 1 and 0.55 mg/L on day 2.[ 4 ] Eight women admitted for cesarean section were given an average of 5 mg/kg (range 3.8 to 6.3 mg/kg) of intravenous thiopental for induction of anesthesia. The highest colostrum level occurred in the first nursing after the termination of anesthesia (about 4 hours after the dose) and was estimated to be 0.34 mg/L. Eight other women who were at least 2 weeks postpartum were given an average of 5.4 mg/kg (range 4.4 to 7 mg/kg) of intravenous thiopental for induction of anesthesia. The highest milk level occurred in the first nursing after the termination of anesthesia (about 4 hours after the dose) and was estimated to be 0.9 mg/L. The authors concluded that the doses received by the infant were negligible and unlikely to affect the infant.[ 1 ] Twenty women undergoing cesarean section received 5 mg/kg of thiopental intravenously for induction of anesthesia. Average colostrum levels were 1.98 mg/L (range 0.6 to 4.7 mg/L) at 30 minutes, 0.91 mg/L (range 0.4 to 1.9 mg/L) at 4 hours, and 0.59 mg/L (range 0.3 to 1.4 mg/L) at 9 hours after the end of the dose.[ 5 ] Infant Levels. Seven mothers received intravenous thiopental for anesthesia induction prior to cesarean section. The half-lives of the drug were calculated in their infants from urinary excretion data. The b

Alternatives LactMed lists

• Dexmedetomidine
• Etomidate
• Methohexital
• Propofol