title: [Effect of indomethacin on the intracranial pressure].
abstract: Twenty patients subjected to craniotomy for supratentorial cerebral tumours were anaesthetized with thiopental, fentanyl, nitrous oxide, and isoflurane. A PaCO2 level averaging 4.8 kPa was achieved. The patients were randomized to intravenous indomethacin 50 mg or placebo administrated after exposure of the dura. A significant decrease in intracranial pressure from 6.5 to 1.5 mmHg (medians) was found after indomethacin administration. This decrease was caused by a significant decrease in cerebral blood flow associated with a significant increase in the arterio-venous oxygen difference. Indomethacin did not affect cerebral oxygen uptake, arteriovenous difference in lactate or the lactate/oxygen index, suggesting that indomethacin did not provoke global cerebral ischaemia. In the indomethacin group, dura was sufficiently relaxed in eight of nine patients, and dura was opened without the occurrence of cerebral swelling. In the placebo group, mannitol supplemented with hypocapnia was applied in five patients. These findings suggest that perioperative treatment with indomethacin is an excellent treatment of intracranial hypertension during normocapnic isoflurane anaesthesia for craniotomy.
authors.affiliation: Arhus Universitetshospital, neuroanaestesiologisk afdeling.
authors.forename: H
authors.initials: H
authors.lastname: Bundgaard
authors.forename: K A
authors.initials: KA
authors.lastname: Jensen
authors.forename: G E
authors.initials: GE
authors.lastname: Cold
authors.forename: B
authors.initials: B
authors.lastname: Bergholt
authors.forename: R O
authors.initials: RO
authors.lastname: Frederiksen
authors.forename: S
authors.initials: S
authors.lastname: Pless
mesh_terms: D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001921:Brain / Q000378:metabolism*; D001932:Brain Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D003399:Craniotomy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage*; D007427:Intracranial Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011292:Premedication
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin
vernacular_title: Indomethacins virkning på det intrakranielle tryk.