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ICP is lower during propofol anaesthesia compared to isoflurane and sevoflurane.
Petersen, K D; Landsfeldt, U; Cold, G E; Pedersen, C B; Mau, S; Hauerberg, J; Holst, P.
Affiliation
  • Petersen KD; Department of Anaesthesia and Neurosurgery, Aarhus University Hospital, Denmark.
Acta Neurochir Suppl ; 81: 89-91, 2002.
Article in En | MEDLINE | ID: mdl-12168367
OBJECTIVES: Propofol is a cerebral vasoconstrictor while inhalation anaesthetics like isoflurane and sevoflurane act as cerebral vasodilators in both animal and human studies. This difference of action upon cerebral vessels might implicate a lower ICP during propofol anaesthesia. Cerebral metabolism is decreased by all three anaesthetics. In a prospective, randomised multicenter study ICP was compared during anaesthesia with propofol, isoflurane and sevoflurane. METHODS: 117 patients subjected to elective craniotomy for supratentorial tumour. Propofol: N = 41; isoflurane: N = 38; sevoflurane: N = 38. Nitrous oxide was omitted and all anaesthetics were supplemented with a continuous infusion of fentanyl. ICP was measured subdurally after removal of the bone flap. MABP, CPP, PCO2, AVDO2, rectal temperature, tumour size and midline shift were registered too. STATISTICS: Kruskal-Wallis Variance on Ranks. All values in medians with range. P < 0.05 was considered significant. RESULTS: ICP (mmHg): propofol 7 (-1-20), isoflurane 12 (1-29), sevoflurane 11 (2-32). ICP was significantly lower in the propofol group compared to the isofluane and sevoflurane groups. CPP (mmHg): propofol 80 (45-104), isoflurane 60 (32-84), sevoflurane 63 (44-77). CPP was significantly higher in the propofol group compared to the isoflurane and sevoflurane groups. AVDO2 (mmol/l): propofol 3.1 (0.9-5.1), isoflurane 2.5 (1.1-4.5), sevoflurane 2.6 (0.8-4.1). AVDO2 was significantly higher in the propofol group compared to the isoflurane and sevoflurane groups. No significant differences in PCO2, rectal temperature, tumour size and midline shift were found. CONCLUSIONS: Subdural ICP is significantly lower during propofol anaesthesia compared to isoflurane and sevoflurane anaesthesia. CPP and AVDO2 are significantly higher during propofol anaesthesia compared to isoflurane and sevoflurane anaesthesia.
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Collection: 01-internacional Database: MEDLINE Main subject: Supratentorial Neoplasms / Intracranial Pressure / Propofol / Isoflurane / Anesthesia, Intravenous / Methyl Ethers Type of study: Clinical_trials / Diagnostic_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Acta Neurochir Suppl Year: 2002 Document type: Article Affiliation country: Denmark Country of publication: Austria
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Collection: 01-internacional Database: MEDLINE Main subject: Supratentorial Neoplasms / Intracranial Pressure / Propofol / Isoflurane / Anesthesia, Intravenous / Methyl Ethers Type of study: Clinical_trials / Diagnostic_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Acta Neurochir Suppl Year: 2002 Document type: Article Affiliation country: Denmark Country of publication: Austria