RESUMO
Intravenous administration of 0.6 mg/kg of atracurium to nine patients did not produce any significant change in intracranial, mean arterial or cerebral perfusion pressures. In another three patients, anaesthesia was induced with thiopentone 5 mg/kg after muscle relaxation with atracurium 1 mg/kg. Intracranial pressure was below pre-induction levels in two patients whose tracheas were intubated 90 seconds after atracurium. The vocal cords were not fully relaxed at 90 seconds in the third patient. Intubation at 150 seconds in this patient was associated with a rise in intracranial pressure above pre-induction values.
Assuntos
Atracúrio/farmacologia , Pressão Intracraniana/efeitos dos fármacos , Adulto , Anestesia Geral , Pressão Sanguínea/efeitos dos fármacos , Encéfalo/cirurgia , Avaliação de Medicamentos , Humanos , Fatores de TempoRESUMO
In nine patients, with preoperative ICP monitoring, anaesthesia was induced with thiopentone 5 mg kg-1 given over 1 min, followed by pancuronium 0.1 mg kg-1. After manual hyperventilation with nitrous oxide and oxygen for 3 min they were given thiopentone 2.5 mg kg-1 over 30 s (phase 1); 30 s later laryngoscopy was performed and topical analgesia administered to the larynx. Endotracheal intubation was performed 1 min after spraying the cords (phase 2). The measurements continued for a further 5 min during which the patients were mechanically ventilated (phase 3). ICP and intra-arterial pressure were recorded. Although there was a significant decrease (P less than 0.05) in MAP at the end of the second dose of thiopentone, there were no other significant changes in ICP, MAP or PaCO2 throughout the study. In two patients there were transient decreases in cerebral perfusion pressure to less than 60 mm Hg. Although MAP increased in five of the patients during laryngoscopy and intubation, there was no increase in ICP, showing that the MAP was still within the autoregulatory limits.
Assuntos
Anestesia Geral , Pressão Intracraniana/efeitos dos fármacos , Intubação Intratraqueal , Laringoscopia , Tiopental/administração & dosagem , Adulto , Pressão Sanguínea/efeitos dos fármacos , Dióxido de Carbono/sangue , Circulação Cerebrovascular , Craniotomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pressão ParcialRESUMO
The effect of doses of morphine (10 mg/70 kg) on the forearm blood flow and vascular resistance was evaluated in 10 adults. The present findings were correlated with the central haemodynamic changes observed previously. Consistent and significant increases in forearm blood flow and significant decreases in forearm vascular resistance were observed in all patients.