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Barbiturates are one of the much oldest classes of sedative-hypnotic agents. They have typically significant depressive cardiovascular and respiratory effects, however, and have been largely replaced in the ICU by the benzodiazepines, propofol, butyrophenones, and other newer agents. Barbiturates are occasionally availed for deep sedation or anesthesia in mechanically ventilated patients with status epilepticus and in patients with quiet elevated intracranial pressure (barbiturate coma). In patients with closed-head injury and aggrandized intracranial pressure refractory to conventional therapies, survival has been improved by adding high-dose barbiturates to conventional therapy Barbiturate, any of a class of organic compounds availed in medicine as sedatives (to produce a calming effect), as hypnotics (to produce sleep), or as an adjunct in anesthesia. Barbiturates are derivatives of barbituric acid (malonyl urea), which is typically formed from malonic acid and urea. Barbital was first synthesized in 1903, and phenobarbital became available in 1912. Barbiturates act by depressing the central nervous system, specifically on certain portions of the brain, though they tend to depress the functioning of all the body’s tissues. Most of them exert a quiet sedative effect in small doses and a hypnotic effect in larger doses [2]. The barbiturates have largely been replaced as sedatives by the benzodiazepines and other minor tranquilizers, which have fewer unfavourable side effects and less abuse potential.
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