Effect of diprivan on intracranial pressure in patients with head injuries

The effects of diprivan bolus dose on intracranial pressure [ICP] were studied in 10 male patients with head injuries and brain oedema. Diprivan 2.0mg/kg injected intravenously over 60s caused statistically significant reduction [p < 0.05] in ICP and cerebral perfusion pressure [CPP] with maximum reduction at 3.0 min. CPP was maintained above 50 mm Hg in all measurements. Arterial blood pressure was decreased significantly [p < 0.05] with the lowest values occurring at 3.0 min for both systolic and mean blood pressure and at 7.0 min for diastolic blood pressure. Heart rate showed no significant change, except at 1-min intervals, where a significant increase was found [p < 0.05]. We conclude that diprivan is effective in lowering ICP, while its lowering effect on CCP needs further investigation

effect of cimetidine, magnesium tri-silicate mixture, and metoclopramide on gastric pH and volume

Surgery patients are considered at risk for pulmonary acid aspiration if the gastric pH is 2.5 or less and/or the gastric aspirate volume is 25 ml or more. This study compares the effect of cimetidine, magnesium tri-silicate [MTS] and metoclopramide on the intragastric volume and pH in 120 elective surgery patients divided into four equal groups. Sixty to ninety minutes before anaesthesia, the cimetidine and metoclopramide groups received 300 and 10 mg i.m., respectively. One hundred twenty minutes before anaesthesia, the MTS group received 30 ml orally. Patients receiving MTS showed the highest gastric pH and intragastric volume. The cimetidine group had the lowest intragastric volume and a significant increase in pH. The metoclopramide group effectively reduced gastric volume but showed no significant effect on pH. We conclude that no single drug can be relied upon to reduce intragastric volume and neutralize gastric acid in all patients