Opioid sedation does not alter intracranial pressure in head injured patients |
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| Authors: | Kathryn K Lauer Lois A. Connolly William T. Schmeling |
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| Affiliation: | (1) Zablocki VA Medical Center, Milwaukee, Wisconsin;(2) Department of Anesthesiology, Froedtert Memorial Lutheran Hospital, 9200 W. Wisconsin Ave, S3226 Milwaukee, WI;(3) Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin |
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| 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 artenal pressure (MAP) were minimized. Methods Fifteen severely head-injured patients (G5C of ≤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. |
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