Controlled Sedation with Alphaxalone-Alphadolone

1974/06/22 by M. A. E. Ramsay, Michael A. E. Ramsay, T.M. Savege +5 · 2,919 citations
Medicine · #Anesthesia #Anesthesia and Sedative Agents #Cardiac, Anesthesia and Surgical Outcomes #Intensive Care Unit Cognitive Disorders #Intensive care medicine #Medicine #Pharmacology #Sedation #Sedative #Tachyphylaxis

paper · pdf · doi:10.1136/bmj.2.5920.656

published in BMJ 2(5920), 656-659

openalex publication_date 1974/06/22 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

Alphaxalone-alphadolone (Althesin), diluted and administered as a controlled infusion, was used as a sedative for 30 patients in an intensive therapy unit. This technique allowed rapid and accurate control of the level of sedation. It had three particularly useful applications: it provided "light sleep," allowed rapid variation in the level of sedation, and enabled repeated assessment of the central nervous system.Sedation was satisfactory for 86% of the total time, and no serious complications were attributed to the use of the drug. Furthermore, though alphaxalone-alphadolone was given for periods up to 20 days there was no evidence of tachyphylaxis or delay in recovery time.

Cited by

• Impact of Intravenous Lidocaine Infusion on Postoperative Analgesia and Recovery from Surgery
• Acetaminophen (Paracetamol) or Opioid Analgesia Added to Ibuprofen for Children’s Musculoskeletal Injury
• Large-scale signatures of unconsciousness are consistent with a departure from critical dynamics
• Sensitivity and Specificity of the Critical-Care Pain Observation Tool for the Detection of Pain in Intubated Adults After Cardiac Surgery
• Palliative Sedation Versus Euthanasia: An Ethical Assessment
• Benzodiazepines for psychosis-induced aggression or agitation
• Emotional electrodermal response in coma and other low-responsive patients
• State Behavioral Scale: a sedation assessment instrument for infants and young children supported on mechanical ventilation. [europepmc]
• Dissociating speech perception and comprehension at reduced levels of awareness. [europepmc]
• Management plan to reduce risks in perioperative care of patients with presumed obstructive sleep apnea syndrome. [europepmc]
• Persistent default-mode network connectivity during light sedation. [europepmc]
• Comparison of different pain scoring systems in critically ill patients in a general ICU. [europepmc]
• The role of neurosteroids in the pathophysiology and treatment of catamenial epilepsy. [europepmc]
• A screening, prevention, and restoration model for saving the injured brain in intensive care unit survivors. [europepmc]
• Propofol anesthesia and sleep: a high-density EEG study. [europepmc]
• Delirium and sedation recognition using validated instruments: reliability of bedside intensive care unit nursing assessments from 2007 to 2010. [europepmc]
• Connectivity changes underlying spectral EEG changes during propofol-induced loss of consciousness. [europepmc]
• Spatiotemporal reconfiguration of large-scale brain functional networks during propofol-induced loss of consciousness. [europepmc]
• General anesthesia and human brain connectivity. [europepmc]
• Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. [europepmc]
• The number of mechanically ventilated ICU patients meeting communication criteria. [europepmc]
• Resting-state Functional Magnetic Resonance Imaging Correlates of Sevoflurane-induced Unconsciousness. [europepmc]
• Complexity of Multi-Dimensional Spontaneous EEG Decreases during Propofol Induced General Anaesthesia. [europepmc]
• Validity of a Modified Sequential Organ Failure Assessment Score Using the Richmond Agitation-Sedation Scale. [europepmc]
• Ventilator-derived carbon dioxide production to assess energy expenditure in critically ill patients: proof of concept. [europepmc]
• Large-scale signatures of unconsciousness are consistent with a departure from critical dynamics. [europepmc]
• Tolerability, response and outcome of high-risk neuroblastoma patients treated with long-term infusion of anti-GD 2 antibody ch14.18/CHO. [europepmc]
• Change in cardiac output during Trendelenburg maneuver is a reliable predictor of fluid responsiveness in patients with acute respiratory distress syndrome in the prone position under protective ventilation. [europepmc]
• Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome. [europepmc]
• Consciousness-specific dynamic interactions of brain integration and functional diversity. [europepmc]
• Guidelines for diagnostic flexible bronchoscopy in adults: Joint Indian Chest Society/National College of chest physicians (I)/Indian association for bronchology recommendations. [europepmc]
• Loss of consciousness reduces the stability of brain hubs and the heterogeneity of brain dynamics. [europepmc]

Related

• Preparation, Premedication, and Surveillance
• Pharmacodynamic Considerations for Moderate and Deep Sedation
• Evidence and consensus based guideline for the management of delirium, analgesia, and sedation in intensive care medicine. Revision 2015 (DAS-Guideline 2015) – short version
• Safe and Effective Conscious Sedation Administered by Dermatologic Surgeons
• Effects of Subanesthetic Oromucosal Dexmedetomidine on Sleep in Humans: A Randomized, Controlled Pharmacokinetics–Pharmacodynamics Study