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Effects of 1% and 2% enflurane on intracranial pressure in man

par Ewalenko, Patricia ;Nubourgh, Yves;Deloof, Thierry ;Vandesteene, Arlette ;De Rood, Monique
Référence Acta Anaesthesiologica Belgica, 31, SUPPL., page (61-71)
Publication Publié, 1980

Article révisé par les pairs

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Résumé :

We have studied the effects of enflurane on intracranial pressure (ICP) in 9 neurosurgical patients, whose ICP was continuously monitored for therapeutic or diagnostic purposes. The control ICP was under 15 Torr in 5 cases, under 20 Torr in 3 cases and 25 Torr in one case. In order to achieve stable ventilatory conditions, the patients were kept under controlled ventilation, breathing a mixture of 60 to 70 % nitrous oxide and oxygen. The Pa(co)2 was kept constant, at the pre-study level. Mean arterial pressure (MAP) was maintained stable with the administration of fluids and/or a phenylephrine drip. Cerebral perfusion pressure (CPP) was calculated as the difference between MAP and mean ICP. After a control stabilization period of about one hour, enflurane was introduced in the circuit at successive concentrations of 1 and 2 % for 20 to 30 minutes. In seven patients, enflurane did not produce any change of ICP. ICP rose only in 2 patients, whose control values were 16 and 25 Torr. The overall changes, however, were not significant. There was a small significant decrease of MAP and CPP under 2% enflurane when compared to control, probably of no clinical importance (under 10% change).