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Cerebrospinal fluid pressure changes during the induction phase of anaesthesia

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Abstract

Cerebrospinal fluid pressure (CSFP) by lumbar puncture, systemic blood pressure (BP) and pulse rate (PR) were measured for 15 minutes during the induction phase of general anaesthesia in seven groups of six healthy female patients each.

Intravenous drugs, thiopentone 5mg.kg-1 alfathesin 50μl . kg-1 and diazepam 0.5 mg. kg-1 given in 10 to 20 seconds caused a fall of CSFP and BP, whereas ketamine 2 mg. kg-1 and a three-minute induction with halothane three per cent, trichloroethylene one percent, or methoxyflurane0.75 percent caused a sharp highly significant but short-lived rise of CSFP. Unlike ketamine, trichlorethylene and methoxyflurane, halothane caused a simultaneous significant fall of BP.

To rule out apprehension as the cause of the rise of CSFP with inhalation agents a second challenge was given with similar concentrations of the vapours while patients were asleep. These still produced a sharp and significant rise of CSFP.

RéSUMé

On a mesuré la pression du liquide céphalo-rachidien (par ponction lombaire), ainsi que la pression artérielle et la fréquence cardiaque durant 15 minutes lors de l’induction de 1’anesthésie chez 42 patientes en bonne santé. Pour les conditions de l’étude, on avait formé sept groupes de six patients chacun, chaque groupe étant assigné àa un agent différent. Le thiopental à la dose de 5mg.kg-1, l’alfathésin a 50μl.kg-1, ainsi que le diazépam à 0.5 mg. kg1- administrés en 10 à 20 secondes, produisaient une chute de pression du LCR et de la pression artérielle, alors que la kétamine à la dose de 2 mg- kg-1, de même qu’une induction par inhalation de trois minutes à l’halothane à 3 pour cent, au trichloroéthylène a 1.0 pour cent ou au methoxyflurane à 0.75 pour cent, amenaient une élévation aiguä et hautement significative, mais de courte durée, de la pression du liquide céphalo-rachidien. Le trichloroéthylène, l’halothane et le méthoxyflurane provoquaient une chute simultanée significative de la pression artérielle. Dans le but d’éliminer l’appréhension comme cause de l’élévation de tension du LCR chez les patientes induites avec un agent d’inhalation, on a réepété 1’administration de ces mêmes agents d’inhalation, aux mêmes concentrations, après stabilisation de 1’anesthésie. On a pu observer la même élévation aiguä et transitoire de la pression du LCR.

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Correspondence to M. M. NaYak or I. M. Bali or H. Singh or Y. K. Batra.

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NaYak, M.M., Bali, I.M., Singh, H. et al. Cerebrospinal fluid pressure changes during the induction phase of anaesthesia. Canad. Anaesth. Soc. J. 27, 464–470 (1980). https://doi.org/10.1007/BF03007045

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Keywords

  • Ketamine
  • Cerebral Blood Flow
  • Halothane
  • Pulse Rate
  • Thiopentone