II. Indications
- Procedural Sedation (esp. Electroconvulsive Therapy or ECT)
III. Contraindications
- Absolute Contraindications
- Acute Intermittent Porphyria
- Barbiturates Hypersensitivity
- Relative Contraindications
- Cardiovascular disease
- Hypotension
- Respiratory depression or uncontrolled respiratory disease
IV. Precautions: Standard Procedural Sedation precautions
- Close cardiopulmonary monitoring (e.g. Pulse Oximetry, Blood Pressure, End-Tidal CO2)
- Airway management (e.g. suction, LMA, Endotracheal Intubation)
- Breathing management (e.g. Supplemental Oxygen, Bag Valve Mask)
V. Mechanism
- See Barbiturate
- Rapid onset, short acting Barbiturate (barbituric acid derivative)
- Cerebral Cortex and cerebellar Sedative-Hypnotic
VI. Dosing
-
Procedural Sedation
- Start: 1 mg/kg IV
- Next: 0.5 mg/kg every 2-5 minutes
- Induction
- See Rapid Sequence Intubation
- Adults: 50-120 mg (mean 70 mg) IV push given as 10 mg (1 ml of 1% solution) every 5 seconds until effect
VII. Pharmacokinetics
- Half-Life: 3-6 hours
- Onset
- IV: Immediate
- IM: 2-10 minutes
- PR: 5-15 minutes
- Duration
- IV: 10-20 minutes
- PR: 45 minutes
- Metabolism
- Slow hepatic metabolism to inactive substances
- Excretion
- Primarily excreted in urine (minimal excretion in sweat and stool)
VIII. Adverse Effects
- See Barbiturates
- See Procedural Sedation
- Laryngospasm (rare)
- Administering additional Methohexital dose typically stops the laryngospasm
- Respiratory Depression or Apnea
- Hiccoughs
- Hypotension
IX. Resources
- Methohexital (Stat Pearls)
X. References
- LoVecchio (2019) Crit Dec Emerg Med 33(7): 28
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Related Studies
Definition (MSH) | An intravenous anesthetic with a short duration of action that may be used for induction of anesthesia. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D008723 |
SnomedCT | 373488009, 39124003 |
LNC | LP18125-2, MTHU003436 |
English | Methohexital, Methohexitone, Methohexital [Chemical/Ingredient], methohexitone, methohexital, Methohexital (product), Methohexital (substance), METHOHEXITAL |
Swedish | Metohexital |
Czech | methohexital |
Finnish | Metoheksitaali |
Russian | METOGEKSITAL, METOGEKSITON, ENALLINIMAL, МЕТОГЕКСИТАЛ, МЕТОГЕКСИТОН, ЭНАЛЛИНИМАЛ |
Japanese | メトヘキシタール, ブレビタール, メトヘキシタールナトリウム, ナトリウムメトヘキシタール, ブレビミタール, ブリエタール, ブリエタールナトリウム, ブレビタールナトリウム, メトヘキシトン |
Italian | Methohexitone, Metohexital |
Polish | Metoheksytal, Enallynymalum |
Spanish | metohexital (producto), metohexital (sustancia), metohexital, metohexitona, Metohexital, Metohexitona |
French | Méthohéxital |
German | Methohexital, Methohexiton |
Portuguese | Metoexital, Metoexitona |
Ontology: Methohexital Sodium (C0304448)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D008723 |
SnomedCT | 333856000, 91594002 |
English | Methohexitone sodium, methohexital sodium, methohexital sodium (medication), Methohexital Sodium [Chemical/Ingredient], sodium methohexital, Methohexital, Monosodium Salt, Monosodium Salt Methohexital, Sodium, Methohexital, Methohexitone sodium (product), Methohexital sodium, Methohexital sodium (substance), Methohexitone sodium (substance), Methohexital Sodium, METHOHEXITAL SODIUM |
Spanish | metohexital sódico (producto), metohexital sódico (sustancia), metohexital sódico, metohexitona sódica (producto), metohexitona sódica |
Ontology: Brevital (C0733444)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D008723 |
English | brevital, Brevital, Jones Brand of Methohexital Sodium |