The effect of skull-pin insertion on cerebrospinal fluid pressure and cerebral perfusion pressure: influence of sufentanil and fentanyl

Détails

ID Serval
serval:BIB_49FDB168BABA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
The effect of skull-pin insertion on cerebrospinal fluid pressure and cerebral perfusion pressure: influence of sufentanil and fentanyl
Périodique
Anesthesia and Analgesia
Auteur(s)
Jamali  S., Archer  D., Ravussin  P., Bonnafous  M., David  P., Ecoffey  C.
ISSN
0003-2999
Statut éditorial
Publié
Date de publication
06/1997
Peer-reviewed
Oui
Volume
84
Numéro
6
Pages
1292-6
Notes
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial --- Old month value: Jun
Résumé
This randomized prospective study measured the effects of an intravenous opioid bolus on cerebrospinal fluid pressure (CSFP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) during skull-pin insertion. Twenty-two adult patients scheduled for elective craniotomy for supratentorial lesions were studied. Outcome variables were MAP, heart rate (HR), and lumbar CSFP. The standardized anesthetic regimen included fentanyl (2 microg/kg), thiopental (5-7 mg/kg), lidocaine (1.5 mg/kg), isoflurane (0.3-0.7 minimum alveolar anesthetic concentration), and vecuronium (0.1 mg/kg). During stable anesthesia, sufentanil (0.8 microg/kg) or fentanyl (4.5 microg/kg) was given as a bolus before skull-pin insertion. The hemodynamic effects of the opioid injection were modified with phenylephrine and/or atropine when indicated. CSFP remained unchanged in both treatment groups. MAP and CPP increased approximately 10 mm Hg after skull-pin insertion (P<0.001). In the sufentanil group, HR decreased approximately 10 bpm after opioid injection and remained decreased throughout the study. In fentanyl-treated patients, HR decreased 8 bpm after opioid injection but returned to preopioid rates after skull-pin insertion. In conclusion, in anesthetized patients, an intravenous bolus of fentanyl or sufentanil prior to skull-pin insertion results in stable values of CSFP, CPP, BP, and HR when the hemodynamic effects of the opioid are modified with phenylephrine and atropine.
Mots-clé
Adjuvants, Anesthesia/therapeutic use Adrenergic alpha-Agonists/therapeutic use Adult Analgesics, Opioid/*pharmacology Atropine/therapeutic use Blood Pressure/drug effects *Bone Nails Cerebrospinal Fluid Pressure/*drug effects Cerebrovascular Circulation/*drug effects Craniotomy/methods Double-Blind Method Fentanyl/*pharmacology Heart Rate/drug effects Humans Injections, Intravenous Intracranial Pressure/*drug effects Perfusion Phenylephrine/therapeutic use Prospective Studies Skull/*surgery Sufentanil/*pharmacology
Pubmed
Web of science
Création de la notice
17/01/2008 17:20
Dernière modification de la notice
20/08/2019 14:57
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