The change in intracranial pressure during induction of anesthesia with fentanyl, propofol and succinylcyholine in neurosurgical patients / 中华麻醉学杂志

ABSTRACT

Objective To investigate the change in intracranial pressure (ICP) during induction of anesthesia with fentanyl, propofol and succinylcholine in neurosurgical patients by measuring cerebral spinal fluid (CSF) pressure at the level of lumbar spine.Methods Twenty ASA Ⅰ or Ⅱ patients (9 males, 11 females) aged 24-54 yrs scheduled for elective craniotomy for intracranial tumor were included in this study. Lumbar puncture was performed at L2,3 or L3,4 interspace with an epidural needle through which an epidural catheter was placed in the subarachnoid space to allow measurement of lumbar CSF pressure. Anesthesia was induced with fentanyl 2-3 ?g?kg-1 followed by propofol 2 mg?kg-1 and succinylcholine 1.5 mg?kg-1. CSF pressure was recorded before induction of anesthesia (baseline value), at 5 min after intravenous fentanyl injection, 1, 2, and 3 min after propofol injection, during fasciculation of muscle and immediately after intubation.Results CSF pressure was significantly decreased at 1, 2 and 3 min after i.v. propofol and during muscle fasciculation. The CSF pressure was lowest at 3 min after propofol injection. Tracheal intubation did not result in significant increase in CSF pressure as compared with the baseline value before induction. Conclusion Intracranial pressure is decreased during induction of anesthesia with fentanyl, propofol and succinylcholine in neurosurgical patients and the adverse effect of tracheal intubation on ICP is effectively blunted.