Faculty Collaboration Database

Opioid sedation does not alter intracranial pressure in head injured patients. Can J Anaesth 1997 Sep;44(9):929-33

Date

09/26/1997

Pubmed ID

9305555

DOI

10.1007/BF03011963

Scopus ID

2-s2.0-0031465389 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

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.

Author List

Lauer KK, Connolly LA, Schmeling WT

Authors

Lois A. Connolly MD Emeritus Professor in the Anesthesiology department at Medical College of Wisconsin
Kathryn K. Lauer MD Emeritus Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adjuvants, Anesthesia
Adolescent
Adult
Analysis of Variance
Blood Pressure
Craniocerebral Trauma
Fentanyl
Glasgow Coma Scale
Heart Rate
Humans
Hypnotics and Sedatives
Infusions, Intravenous
Intracranial Pressure
Middle Aged
Monitoring, Physiologic
Morphine
Narcotics
Sufentanil