Effect of a Bolus Dose of an Analgetic on Subdural Intracranial Pressure and Cerebral Haemodynamics During General Anaesthesia for Craniotomy in Patients with Supratentorial Cerebral Tumours
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Many studies regarding the effects of synthetic opioids on ICP, arteriovenous oxygen difference, mean arterial blood pressure and the CO2 reactivity have been carried out. Contradictory results have been obtained. This, however, is most likely due to different study designs and to different patient populations studied. The overall result seems to be that these opioids depress the blood pressure in a dose-related way. This blood pressure decrease may affect the cerebral parameters depending on whether cerebral autoregulation is intact or not. In this chapter three studies regarding analgetic boluses and the influence on the cerebral haemodynamics are presented. A bolus dose of alfentanil during propofol-fentanyl maintenance, a bolus dose of remifentanil during propofol-remifentanil anaesthesia and a bolus dose of fentanyl during propofol-fentanyl anaesthesia were studied.
KeywordsCerebral Perfusion Pressure Bolus Dose Regional Cerebral Blood Flow Cerebral Autoregulation Severe Head Injury
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