I have a comment on the research by Azam¹. I am extremely grateful for detailed study in Lahore, Pakistan. The author investigated the effect of thiopental on pain reduction of propofol. Thiopental is popular and widely using drug in operating room. I have some additional point about caution of thiopental as followings:

First, mixing thiopental and rocuronium produce a flaky precipitate². No fluid running is the main cause of crystal formation.

Second, intraarterial injection of thiopental leads to gangrene³. Inadvertent injection usually occurs in radial artery.

Third, extravasation of thiopental generates collagen destruction, vasoconstriction, apoptosis and edema⁴. Sodium thiopental is a strong alkali, pH 10-11. This error also reaches deep tissue necrosis.