Utilisation clinique du propofol en neuroanesthesie. [Clinical use of propofol in neuroanesthesia]

Details

Serval ID
serval:BIB_464F6DDF7B3B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Utilisation clinique du propofol en neuroanesthesie. [Clinical use of propofol in neuroanesthesia]
Journal
Agressologie
Author(s)
Ravussin  P., Revelly  J. P., Chiolero  R.
ISSN
0002-1148 (Print)
Publication state
Published
Issued date
1991
Volume
32
Number
8-9 Spec No
Pages
407-11
Notes
English Abstract
Journal Article
Abstract
Since Althesin was withdrawn from the market, and since Ledingham's report on the inhibitory effect of etomidate on cortisol secretion, anaesthesia in intracranial surgery has lacked an intravenous agent with a pharmacokinetic-dynamic profile making it a suitable alternative to the classic thiopental-isoflurane sequence. Propofol has been used experimentally in neuroanaesthesia for 4 years, and is now ready to be used on a routine basis in neuroanaesthesia. An induction dose of propofol decreases cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMR02), and intracranial pressure (ICP). Mean arterial pressure (MAP) is only moderately decreased if propofol is given as a mini-infusion instead of being given on a mg/kg basis. The intraoperative dosage is low (50-100 micrograms.kg-1 x min-1) due to the fact that intracerebral surgery is not painful. Recovery can thus be rapid. Propofol is used with the same agents or manoeuvres as those used with the thiopental-isoflurane sequence, i.e. lidocaine, fentanyl, esmolol, mannitol, steroids, hyperventilation and lumbar drainage in order to obtain the most relaxed brain and reduce the mechanical pressure exerted on the brain. Propofol can be used for all intracranial pathologies with may be one exception, when a cerebral aneurysm has to be clipped and vasospasm is present.
Keywords
Anesthesia, Intravenous/*methods Cerebrovascular Circulation/drug effects Craniotomy Humans Intracranial Pressure/drug effects Nervous System Diseases/surgery *Neurosurgery *Propofol
Pubmed
Create date
24/01/2008 17:03
Last modification date
20/08/2019 13:51
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