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Titolo:
KETAMINE DECREASES INTRACRANIAL-PRESSURE AND ELECTROENCEPHALOGRAPHIC ACTIVITY IN TRAUMATIC BRAIN INJURY PATIENTS DURING PROPOFOL SEDATION
Autore:
ALBANESE J; ARNAUD S; REY M; THOMACHOT L; ALLIEZ B; MARTIN C;
Indirizzi:
HOP NORD MARSEILLE,SERV EXPLORAT FONCTIONNELLE SYST NERVEUX,DEPT ANESTHESIE REANIMAT F-13195 MARSEILLE 20 FRANCE HOP NORD MARSEILLE,SERV NEUROCHIRURG F-13195 MARSEILLE 20 FRANCE
Titolo Testata:
Anesthesiology
fascicolo: 6, volume: 87, anno: 1997,
pagine: 1328 - 1334
SICI:
0003-3022(1997)87:6<1328:KDIAEA>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL BLOOD-FLOW; EXPERIMENTAL HEAD TRAUMA; METABOLISM; ANESTHESIA; CRANIOTOMY; MIDAZOLAM; INDUCTION; VELOCITY; RATS;
Keywords:
ANESTHETICS, KETAMINE; BRAIN, INTRACRANIAL PRESSURE; TRAUMA, HEAD;
Tipo documento:
Article
Natura:
Periodico
Citazioni:
20
Recensione:
Indirizzi per estratti:
Citazione:
J. Albanese et al., "KETAMINE DECREASES INTRACRANIAL-PRESSURE AND ELECTROENCEPHALOGRAPHIC ACTIVITY IN TRAUMATIC BRAIN INJURY PATIENTS DURING PROPOFOL SEDATION", Anesthesiology, 87(6), 1997, pp. 1328-1334

Abstract

Background: The potential adverse effects of ketamine in neurosurgical anesthesia have been well established and involve increased intracranial pressure (ICP) and cerebral blood flow. However, reexamination ofketamine is warranted because data regarding the effects of ketamine on cerebral hemodynamics are conflicting. Methods: Eight patients withtraumatic brain injury were studied, In all patients, PCP monitoring tvas instituted before the study. Control of ICP (less than 25 mmHG), hemodynamic values, and blood gas tension (partial pressure of carbon dioxide In arterial blood between 35-38 mmHg) was obtained with propofol infusion (3 mg.kg(-1).h(-1)) and mechanical ventilation, The effects of three doses of ketamine, 1.5, 3, and 4 mg/kg , respectively, on ICP, cerebral perfusion pressure, jugular vein bulb oxygen saturation, middle cerebral artery blood flow velocity, and electric activity of the brain (EEG) were measured. The three doses were administered intravenously at Gh intervals over 30 s through a central venous line. Systemic and cerebral hemodynamics and end-tidal carbon dioxide were continuously monitored and recorded at 1-min intervals throughout the 30-minstudy periods. Results: Ketamine, in all three doses studied (1.5, 3,and 5 mg/kg) was associated with a significant decrease in ICP (mean /- SD: 2 +/- 0.5 mmHg [P < 0.05], 4 +/- 1 mmHg [P < 0.05], and 5 +/- 2 mmHg [P < 0.05]) among the study patients regardless of the ketaminedose used, There were no significant differences in cerebral perfusion pressure, jugular vein bulb oxygen saturation, and middle cerebral artery blood flow-velocity. Ketamine induced a low-amplitude fast-activity electroencephalogram, with marked depression, such as burst suppression. Conclusions: These results suggest that ketamine may not adversely alter cerebral hemodynamics of mechanically ventilated head-traumapatients sedated with propofol. These encouraging results should be confirmed in larger groups of similar patients.

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Documento generato il 05/12/20 alle ore 13:34:32