{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:17:36Z","timestamp":1792682256837,"version":"4.5.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Thiopentone sodium is one of the important drugs in the armamentarium for terminating refractory status epilepticus, a neurological emergency. We report a case of thiopentone-related bradycardia during the management of the new onset refractory status epilepticus in a young man, which was circumvented by prophylactic insertion of temporary pacemaker while thiopentone infusion was continued. A systematic approach was employed to manage the status epilepticus, including infusion of thiamine and glucose followed by antiepileptic drugs. The patient was ventilated and infused with lorazepam, phenytoin, sodium valproate, levetiracetam and midazolam followed by thiopentone sodium. With the introduction of thiopentone the seizures could be controlled but the patient developed severe bradycardia and junctional rhythm. The bradycardia disappeared when thiopentone was withdrawn and reappeared when the drug was reintroduced. Propofol infusion was tried with no respite in seizures. Later thiopentone sodium was reintroduced after inserting temporary cardiac pacemaker. Seizure was controlled and patient was weaned off the ventilator.<\/jats:p>","DOI":"10.1136\/bcr-2013-200484","type":"journal-article","created":{"date-parts":[[2013,10,15]],"date-time":"2013-10-15T10:03:20Z","timestamp":1381831400000},"page":"bcr2013200484","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Transient bradycardia induced by thiopentone sodium: a unique challenge in the management of refractory status epilepticus"],"prefix":"10.1136","volume":"2013","author":[{"given":"Sushma","family":"Sharma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep P","family":"Nair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Murgai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja J","family":"Selvaraj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,10,15]]},"reference":[{"issue":"(Suppl II)","key":"2025042709292144000_2013.oct15_1.bcr2013200484.1","first-page":"ii22","article-title":"The management of status epilepticus","volume":"2013","author":"Shorvon","year":"2001","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.2","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/j.1468-1331.2009.02917.x","article-title":"EFNS guideline on the management of status epilepticus in adults","volume":"2013","author":"Meierkord","year":"2010","journal-title":"Eur J Neurol"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.3","doi-asserted-by":"crossref","first-page":"417","DOI":"10.47102\/annals-acadmedsg.V34N7p417","article-title":"The NORSE (new-onset refractory status epilepticus) syndrome: defining a disease entity","volume":"2013","author":"Wilder-Smith","year":"2005","journal-title":"Ann Acad Med Singap"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.4","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1136\/jnnp.74.8.1095","article-title":"The management of refractory generalised convulsive and complex partial status epilepticus in three European countries: a survey among epileptologists and critical care neurologists","volume":"2013","author":"Holtkamp","year":"2003","journal-title":"J Neurol Neurosurg Psychiatr"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/j.1399-6576.1992.tb03483.x","article-title":"Complications and side effects during thiopentone therapy in patients with severe head injuries","volume":"2013","author":"Schal\u00e9n","year":"1992","journal-title":"Acta Anaesthesiol Scand"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.6","doi-asserted-by":"crossref","first-page":"333","DOI":"10.5414\/CNP71333","article-title":"Sequential occurrence of life-threatening hypokalemia and rebound hyperkalemia associated with barbiturate coma therapy","volume":"2013","author":"Jung","year":"2009","journal-title":"Clin Nephrol"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.7","first-page":"158","article-title":"Fatal ventricular fibrillation following intravenous sodium diphenylhydantoin therapy","volume":"2013","author":"Gellerman","year":"2002","journal-title":"Ann Med Int"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.8","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/00003643-200105000-00005","article-title":"Human cardiac sodium channels are affected by pentobarbital","volume":"2013","author":"Wartenberg","year":"2001","journal-title":"Eur J Anaesthesiol"},{"key":"2025042709292144000_2013.oct15_1.bcr2013200484.9","doi-asserted-by":"crossref","first-page":"367","DOI":"10.4070\/kcj.2009.39.9.367","article-title":"Prognosis and natural history of drug-related bradycardia","volume":"2013","author":"Lee","year":"2009","journal-title":"Korean Circ J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-200484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T16:29:27Z","timestamp":1745771367000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-200484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,15]]},"references-count":9,"alternative-id":["10.1136\/bcr-2013-200484"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-200484","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,15]]}}}