title: Effects of propofol on cerebral hemodynamics and metabolism in patients with brain trauma.
abstract: The authors determined the effect of propofol on cerebral blood flow, intracranial pressure, and cerebral arteriovenous oxygen content difference in severely brain-injured patients during orthopedic treatment of fractures of the extremities. The Glasgow Coma Scale score was 6 or 7 at the time of the study. Data were collected in the operating room before and during (5 and 15 min) administration of propofol (2 mg/kg iv bolus immediately followed by a 150 micrograms.kg-1.min-1 infusion) before surgical stimulation. Propofol was infused during 41.4 +/- 7.3 min. After operation, the last set of measurements was made 15 min after propofol was stopped. The study was performed on 10 adults (age range, 15-40 yr) whose lungs were mechanically ventilated (air/O2) and who were sedated (phenoperidine, 1 mg/h), and was conducted using a radial artery cannula; a 7.5-Fr, thermodilution, flow-directed, pulmonary artery catheter; an intraventricular catheter; and a catheter in the jugular venous bulb. The 133xenon intra-internal carotid artery injection technique was used to determine regional cerebral blood flow (rCBF). Anesthetic blood concentration of propofol (3-5 micrograms/ml) was associated with decreases in cerebral perfusion pressure (CPP; from 82 +/- 14 to 59 +/- 7 mmHg; P less than 0.001), rCBF (from 35 +/- 6 to 26 +/- 5 ml.100 g-1.min-1; P less than 0.001), and intracranial pressure (ICP; from 11.3 +/- 2.6 to 9.2 +/- 2.5 mmHg; P less than 0.001). Cerebrovascular resistance and cerebral arteriovenous oxygen content difference were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Département d'Anesthésiologie et Réanimation Chirurgicale, Hôtel-Dieu, Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Pinaud
authors.forename: J N
authors.initials: JN
authors.lastname: Lelausque
authors.forename: A
authors.initials: A
authors.lastname: Chetanneau
authors.forename: N
authors.initials: N
authors.lastname: Fauchoux
authors.forename: D
authors.initials: D
authors.lastname: Ménégalli
authors.forename: R
authors.initials: R
authors.lastname: Souron
mesh_terms: D000368:Aged; D000777:Anesthetics / Q000494:pharmacology*; D001930:Brain Injuries / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010313:Partial Pressure; D015742:Propofol / Q000494:pharmacology*
chemical_list: D000777:Anesthetics; D002245:Carbon Dioxide; D015742:Propofol