Sédation par propofol à débit constant chez le traumatisé crânien. Résultats préliminaires

Mangez, J.-F.; Menguy, E.; Roux, Patricia

doi:10.1016/s0750-7658(87)80055-2

Cited by 11 publications

(2 citation statements)

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“…Decreased cerebral metabolic rate reduces cerebral blood perfusion, which is known to reduce cerebral blood flow and ICP [ 21 ]. In addition, previous human and animal studies determined that propofol led to a progressive decrease in ICP [ 22 – 24 ]. In particular, ICP tended to decrease over time during the continuous administration of propofol.…”

Section: Discussionmentioning

confidence: 99%

Propofol attenuates the increase of sonographic optic nerve sheath diameter during robot-assisted laparoscopic prostatectomy: a randomized clinical trial

Hong

Park

et al. 2018

BMC Anesthesiol

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BackgroundRobot-assisted laparoscopic prostatectomy (RALP) requires pneumoperitoneum and the Trendelenburg position to optimize surgical exposure, which can increase intracranial pressure (ICP). Anesthetic agents also influence ICP. We compared the effects of propofol and sevoflurane on sonographic optic nerve sheath diameter (ONSD) as a surrogate for ICP in prostate cancer patients who underwent RALP.MethodsThirty-six patients were randomly allocated to groups receiving propofol (propofol group, n = 18) or sevoflurane (sevoflurane group, n = 18) anesthesia. The ONSD was measured 10 min after induction of anesthesia in the supine position (T1); 5 min (T2), 30 min (T3), and 60 min (T4) after establishing pneumoperitoneum and the Trendelenburg position; and at the end of surgery after desufflation in the supine position (T5). Respiratory and hemodynamic variables were also evaluated.ResultsThe ONSD was significantly different between the propofol group and the sevoflurane group at T4 (5.27 ± 0.35 mm vs. 5.57 ± 0.28 mm, P = 0.007), but not at other time points. The ONSDs at T2, T3, T4, and T5 were significantly greater than at T1 in both groups (all P < 0.001). Arterial carbon dioxide partial pressure, arterial oxygen partial pressure, peak airway pressure, plateau airway pressure, systolic blood pressure, pulse pressure variation, body temperature and regional cerebral oxygen saturation, except heart rate, were not significantly different between the two groups.ConclusionsThe ONSD was significantly lower during propofol anesthesia than during sevoflurane anesthesia 60 min after pneumoperitoneum and the Trendelenburg position, suggesting that propofol anesthesia may help minimize ICP changes in robotic prostatectomy patients.Trial registrationClinicaltrials.gov identifier: NCT03271502. Registered August 31, 2017.

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Section: Discussionmentioning

confidence: 99%

Propofol attenuates the increase of sonographic optic nerve sheath diameter during robot-assisted laparoscopic prostatectomy: a randomized clinical trial

Hong

Park

et al. 2018

BMC Anesthesiol

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“…Propofol also reduces cerebral blood flow and metabolism in patients (Stephan et al, 1986). When administered continuously to humans with head injury propofol reduced maximally intracranial pressure by 40% without adversely affecting perfusion pressure (Mangez et al, 1987). We cannot exclude some protective effect of propofol in these studies, but the same would be true if we had used pentobarbital.…”

Section: Discussionmentioning

confidence: 89%

Early Assessment of Neurologic Deficits in the Fluid Percussion Model of Brain Injury

Hilton¹,

Einhaus²,

Meric³

et al. 1993

Journal of Neurotrauma

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This study was designed to quantify the early neurologic effects of brain injury elicited by fluid percussion to the dura of cats. Propofol was used for surgical anesthesia because recovery in normal animals from an intravenous infusion was found to be nearly complete within 2 h of cessation and absolutely complete by 4 h. In addition, a cat coma scale (CCS) was developed that reflects normal (CCS, 14) to moribund (CCS, 3) behavior. The CCS values at 6 h were compared with the force of injury expressed in atmospheres (atm), maximum blood pressure change, and gross neuropathology to ascertain which parameter might best account for the behavior observed after brain injury. The results showed that decreasing neurologic scores correlated well with increasing atmospheres of injury (Pearson's r 0.71, p < 0.001) but not with the rise in systolic blood pressure caused by the trauma (n = 29). Coma scores did correlate with the cross sectional area of ponto-mesencephalic lesions (Pearson's r = 0.51, p < 0.01) and proved to be significantly different in animals grouped according to lesion size of less or more than 3 mm in length (t test, p < 0.01). Thus the CCS and the pharmacologic properties of propofol permit an early analysis of the neurologic status in the feline fluid percussion model of brain injury. These procedures could facilitate the evaluation of early biochemical changes that affect behavior and of therapies designed to ameliorate the deleterious effects of head injury.

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Sedation in the Intensive Care Unit: Challenges, Outcomes, and Future Strategies

Tobias

2011

Pediatric Sedation Outside of the Operating Room

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Sédation par propofol à débit constant chez le traumatisé crânien. Résultats préliminaires

Cited by 11 publications

References 2 publications

Propofol attenuates the increase of sonographic optic nerve sheath diameter during robot-assisted laparoscopic prostatectomy: a randomized clinical trial

Propofol attenuates the increase of sonographic optic nerve sheath diameter during robot-assisted laparoscopic prostatectomy: a randomized clinical trial

Early Assessment of Neurologic Deficits in the Fluid Percussion Model of Brain Injury

Sedation in the Intensive Care Unit: Challenges, Outcomes, and Future Strategies

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