Gamma-hydroxybutyrate: an 'old' and very interesting drug: new perspectives?

Background and goal of study

Due to the unique property of lacking cardiovasculary and respiratory depressive effects, GHB is a very interesting alternative for sedation of critically ill patients.

Materials and methods

An epileptogenic effect described in some animals after high doses of GHB has not been seen in 20 patients analysed with on-line EEG under bolus-application and 20 min afterwards. We also show that the long duration of the effect of a single or repetitive dose of GHB can in fact be reversed by the application of Physostigmine.

Results and discussions

No signs of cerebral hyperexcitability were found in 20 patients receiving an anesthetic dosage of GHB. The problem of sodium-overload should not be an argument any longer as soon as the newly developed, sodium-free drug is available. The third argument against this drug, meaning the long and individually not calculable time of effect, does also not seem to be a good argument against it's use, since anaesthesia from GHB can be antagonized quickly by the application of physostigmine.

Conclusions

GHB is a very interesting drug for anaesthesia and sedation on ICU due to its missing depressive cardiovasculary and respiratory effects and many more aspects. So people should not allow themselves not to use that drug on their patients for the three most usually uttered reasons being sodium overload, cerebral convulsions and long and uncalculable time of action. All these arguments seem untrue.