Abstract
Three patients with severe tetanus were successfully treated by barbital therapy.
In the management of tetanus it is important to provide treatment for frequently occurring convulsion or an accumulated convulsive status in addition to antitoxin therapy. The present three patients with severe tetanus showed almost complete suppression of convulsion by administration of thiamylal at a maintenance dose of 4 mg/kg/h. It is necessary, however, to take into account the necessity of using an artificial ventilator, possible occurrence of pulmonary complications accompanied by increased sputum production, heart failure and hypotension. Medication should be discontinued after the dose has been gradually decreased for 2-3 days, when the convulsion has been completely suppressed for 1-2 weeks after initiation of the therapy.
