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Titolo:
SUFENTANIL INCREASES INTRACRANIAL-PRESSURE IN PATIENTS WITH HEAD TRAUMA
Autore:
ALBANESE J; DURBEC O; VIVIAND X; POTIE F; ALLIEZ B; MARTIN C;
Indirizzi:
HOP NORD MARSEILLE,DEPT ANESTHESIE RENIMAT,CHEMIN BOURRELLY F-13915 MARSEILLE 20 FRANCE HOP NORD MARSEILLE,DEPT ANESTHESIA & INTENS CARE F-13915 MARSEILLE 20FRANCE HOP NORD MARSEILLE,DEPT NEUROSURG F-13915 MARSEILLE 20 FRANCE HOP NORD MARSEILLE,SERV NEUROCHIRURG F-13915 MARSEILLE 20 FRANCE
Titolo Testata:
Anesthesiology
fascicolo: 3, volume: 79, anno: 1993,
pagine: 493 - 497
SICI:
0003-3022(1993)79:3<493:SIIIPW>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
VASCULAR-RESISTANCE; BLOOD-FLOW; FENTANYL; ALFENTANIL; METABOLISM; DOGS;
Keywords:
ANESTHETICS, OPIOID; SUFENTANIL; BRAIN, INTRACRANIAL PRESSURE; TRAUMA, HEAD;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
17
Recensione:
Indirizzi per estratti:
Citazione:
J. Albanese et al., "SUFENTANIL INCREASES INTRACRANIAL-PRESSURE IN PATIENTS WITH HEAD TRAUMA", Anesthesiology, 79(3), 1993, pp. 493-497

Abstract

Background. Sufentanil is an intravenous opioid often used as a component of anesthesia during neurosurgical procedures. However, the effects of sufentanil on intracranial pressure in patients with diminished intracranial compliance are not well established, and remain controversial. Methods: Ten patients with head trauma, in each of whom the trachea was intubated, were studied for the effects of sufentanil on intracranial pressure (ICP) and on cerebral perfusion pressure (CPP). In all patients, ICP monitoring was instituted before the study. Sedation was obtained using a propofol infusion, and paralysis was achieved withvecuronium. After obtaining control of ICP (between 15 and 25 mmHg) hemodynamic values and blood gas tensions (Pa(CO2) between 30 and 35 mmHg), the level of sedation was deepened with an intravenous injection of sufentanil (1 mug/kg over 6 min), followed by an infusion of 0.005 mug . kg-1 min-1. Mean arterial pressure (MAP), ICP (fiberoptic intracranial pressure monitor), and end-tidal CO2 were continuously measuredand recorded at 1-min intervals throughout the 30-min study period. Results: Sufentanil injection was associated with a statistically significant increase in ICP of 9 +/- 7 mmHg (+ 53%), which peaked at 5 min. Then ICP gradually decreased and returned to baseline after 15 min. This was accompanied by a significant decrease in MAP (24% decrease) and, thus, CPP (38% decrease). After 5 min, MAP and CPP gradually increased, but remained significantly decreased throughout the study. Conclusions: The results of the current study indicate that caution should be exercised in the administration of sufentanil bolus to patients withabnormal intracranial elastance, particularly if ICP is significantlyincreased.

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Documento generato il 05/12/20 alle ore 14:03:31