The effects of droperidol and fentanyl on intracranial pressure and cerebral perfusion pressure in neurosurgical patients.

The effects of droperidol and fentanyl on the intracranial pressure (i.c.p.) and cerebral perfusion pressure (c.p.p.) were studied in eight anaesthetized normocapnic patients with intracranial space-occupying lesions. The infection of droperidol resulted in a small and not significant increase in i.c.p. from 24.0 to 27.2 mm Hg, while c.p.p. decreased from 75.9 mm Hg to 57.8 mm Hg, as a result of a decrease in systemic arterial pressure. The addition of fentanyl produced no change in i.c.p., but a further decrease in arterial pressure decreased c.p.p. from 60.4 mm Hg to 47.8 mm Hg. In four patients values of c.p.p. less than 40 mm Hg were obtained. C.p.p. was was increased by hyperventilation in all but one of these patients. It is concluded that droperidol and fentanyl should be used in patients with intracranial hypertension only if hypocapnia has been established and when the arterial pressure is normal or increased.