[Intracranial pressure response during secretion aspiration after administration of a muscle relaxant]. / Respuesta de la presión intracraneal durante la aspiración de secreciones previa administración de un relajante muscular.

UNLABELLED: Aspiration of secretions is a usual nursing technique in patients undergoing mechanical ventilation that may be the cause of increased Intracranial Pressure (ICP). OBJECTIVE: This study aims to evaluate the repercussion of a muscle relaxant on ICP with secretion aspiration. METHOD: Clinical trial using the same patient as case and control, performing two endotracheal aspirations in each patients, on of them after administration of a muscle relaxant (Cis-Atracurium) and another no. The bolus administration of the relaxant in the first or second aspiration was done randomly. Thirteen patients with intraparenchymatous ICP measurement catheter were studied within the first 36 hours post-placement and with sedoanalgesia for a score of 6 on the Ramsay scale. ICP and CPP were measured before, during and after each aspiration. STATISTICAL METHOD: SPSS 11.0 program was used. Data analysis by Student's t test for paired data. Statistical significance level accepted was 95%. RESULTS: On comparing the cases in which muscle relaxant was administered with those in which it was not administered, statistically significant differences were found in the ICP and CCP values during secretion aspiration. CONCLUSIONS: According to the data obtained in the study, a lower increase of ICP was observed during secretion aspiration in those cases in which muscle relaxant was administered prior to the aspiration.

Respuesta de la presión intracraneal durante la aspiración de secreciones previa administración de un relajante muscular / Intracranial pressure response during secretion aspiration after administration of a muscle relaxant

La aspiración de secreciones es una técnica de enfermería habitual en los pacientes sometidos a ventilación mecánica, que puede ser causa de elevación de la presión intracraneal (PIC). Objetivo: El objetivo del estudio es valorar la repercusión de un relajante muscular sobre la PIC ante la aspiración de secreciones. Material y métodos: Ensayo clínico que tomaba al mismo paciente como caso y control, se realizaron 2 aspiraciones endotraqueales a cada paciente, una de ellas previa a la administración de un relajante muscular (cisatracurio) y otra no. La administración en bolo del relajante en la primera o segunda aspiración se realizó de forma aleatoria. Se estudiaron 13 pacientes portadores de catéter de medición de PIC intraparenquimatoso dentro de las primeras 36 h poscolocación y sedoanalgesiados para una puntuación de 6 en la escala de Ramsay. Se midió la PIC y la presión de perfusión cerebral (PPC) antes, durante y después de cada aspiración. Metodología estadística: se utilizó el programa SPSS 11.0. Análisis de datos mediante la t de Student para datos apareados. El nivel de significación estadística aceptado fue del 95%. Resultados: Al comparar los casos en los que se administró relajante muscular con los que no se administró, se encontraron diferencias significativas en los valores de PIC y PPC durante la aspiración de secreciones. Conclusiones: Según los datos obtenidos en el estudio, se ha observado menor aumento de la PIC durante la aspiración de secreciones en los casos en los que se administró el relajante muscular previo a la aspiración

Aspiration of secretions is a usual nursing technique in patients undergoing mechanical ventilation that may be the cause of increased Intracranial Pressure (ICP). Objective: This study aims to evaluate the repercussion of a muscle relaxant on ICP with secretion aspiration. Method: Clinical trial using the same patient as case and control, performing two endotracheal aspirations in each patients, on of them after administration of a muscle relaxant (Cis-Atracurium) and another no. The bolus administration of the relaxant in the first or second aspiration was done randomly. Thirteen patients with intraparenchymatous ICP measurement catheter were studied within the first 36 hours post-placement and with sedoanalgesia for a score of 6 on the Ramsay scale. ICP and CPP were measured before, during and after each aspiration. Statistical method: SPSS 11.0 program was used. Data analysis by Student's t test for paired data. Statistical significance level accepted was 95%. Results: On comparing the cases in which muscle relaxant was administered with those in which it was not administered, statistically significant differences were found in the ICP and CCP values during secretion aspiration. Conclusions: According to the data obtained in the study, a lower increase of ICP was observed during secretion aspiration in those cases in which muscle relaxant was administered prior to the aspiration