Canadian journal of anaesthesia = Journal canadien d'anesthesie · 1997
Opioid sedation does not alter intracranial pressure in head injured patients.
Клиническое исследованиеСравнительное исследованиеСтатьяРандомизированное исследованиеПоддержка правительства СШАНазвание и аннотация: Перевод в очереди
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Lauer K K, Connolly L A, Schmeling W T
Аннотация
PURPOSE: This study aimed to examine the effects of sedative doses of morphine, fentanyl and sufentanil on intracranial pressure (ICP) in head-injured patients in whom changes in mean arterial pressure (MAP) were minimized.
METHODS: Fifteen severely head-injured patients (GSC of < or = 8) were randomly assigned to receive either fentanyl, sufentanil or morphine, titrating the drug to a maximal 10% decrease in MAP. The patients were subsequently given an infusion of the same opioid. For four hours, ICP, MAP and heart rate were recorded.
RESULTS: In all groups, there were no increases in ICP. There was a decrease in MAP in the sufentanil group at 10 min (P < 0.05) and 45 min after the initial opioid bolus. These decreases in MAP were not associated with increases in ICP.
CONCLUSION: The study suggests that when opioids are titrated in head-injured patients, worsening intracranial pressure can be avoided.
METHODS: Fifteen severely head-injured patients (GSC of < or = 8) were randomly assigned to receive either fentanyl, sufentanil or morphine, titrating the drug to a maximal 10% decrease in MAP. The patients were subsequently given an infusion of the same opioid. For four hours, ICP, MAP and heart rate were recorded.
RESULTS: In all groups, there were no increases in ICP. There was a decrease in MAP in the sufentanil group at 10 min (P < 0.05) and 45 min after the initial opioid bolus. These decreases in MAP were not associated with increases in ICP.
CONCLUSION: The study suggests that when opioids are titrated in head-injured patients, worsening intracranial pressure can be avoided.