Comparison of the effects of sevoflurane and isoflurane on intracranial pressure in neurosurgical patients / 中华麻醉学杂志

ABSTRACT

To evaluate the effects of sevoflurane and isoflurane at 1.0 minimum alveolar concentration (MAC) on intracranial pressure(ICP) in patients undergoing craniotomy.Method:Sixteen patients without pre-existing increased ICP subjected to craniotomy for pituitary adenoma or craniopharyngioma were intubated with midazolam, fentanyl and atracurium.After intubation,midazolam and atracurium were pumped intravenously for 30 min.Then,sevoflurane or isoflurane was inhaled and the patients were randomly divided into two groupsA1.0 MAC sevofluraneB1.0 MAC isoflurane.In the whole procedure,PaCO_2 with an average of 5.3 kPa was maintained. ICP was measured continuously by placement of a catheter into lumbar subarachoid space.Result:Sevoflurane maintained cerebral perfusion pressure slightly better than equipotent dose of isoflurane. During sevoflurane administration at 1.0 MAC.ICP decreased slighly,then increased gradually.However,ICP remained stable in group B.Conclusion:Sevoflurane and isoflurane at 1.0 MAC,Combined with midazolam and fentanyl,can be administered safely to the patients without preexisting increased ICP.