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

Détails

ID Serval
serval:BIB_464F6DDF7B3B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Utilisation clinique du propofol en neuroanesthesie. [Clinical use of propofol in neuroanesthesia]
Périodique
Agressologie
Auteur(s)
Ravussin  P., Revelly  J. P., Chiolero  R.
ISSN
0002-1148 (Print)
Statut éditorial
Publié
Date de publication
1991
Volume
32
Numéro
8-9 Spec No
Pages
407-11
Notes
English Abstract
Journal Article
Résumé
Since Althesin was withdrawn from the market, and since Ledingham's report on the inhibitory effect of etomidate on cortisol secretion, anaesthesia in intracranial surgery has lacked an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.
Mots-clé
Anesthesia, Intravenous/*methods Cerebrovascular Circulation/drug effects Craniotomy Humans Intracranial Pressure/drug effects Nervous System Diseases/surgery *Neurosurgery *Propofol
Pubmed
Création de la notice
24/01/2008 18:03
Dernière modification de la notice
03/03/2018 16:47
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