Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0268318 (ICP)
 10,007 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cerebral blood volume (CBV) and intracranial (ICP) were examined in dogs during 3.5 h anesthesia with isoflurane (1.4% expired) or fentanyl (continuous intravenous infusion), and after decreasing the concentration of isoflurane to less than 0.15% expired or discontinuing administration of fentanyl. Isoflurane (1.4%) increased CBV 9-11% for greater than 3 h but increased ICP for only the first 21.7 +/- 1.4 min (mean +/- SEM). Fentanyl decreased CBV 7-10% for greater than 3 h but decreased ICP for only the first 20.3 +/- 2.7 min. Because both halothane or enflurane increase ICP for greater than 3 h in this model, both isoflurane or fentanyl may be preferred to halothane or enflurane for patients at risk for increased ICP.
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PMID:Relationship between cerebral blood volume and CSF pressure during anesthesia with isoflurane or fentanyl in dogs. 673 13

Despite opioids are routinely used for analgesia in head injured patients, the effects of such drugs on ICP and cerebral hemodynamics remain controversial. Cerebrovascular autoregulation (CAR) could be an important factor in the ICP increases reported after opioid administration. In order to describe the effects on intracranial pressure of fentanyl and correlated such effects with autoregulation status, we studied 30 consecutive severe head injury patients who received fentanyl (2 micrograms/kg) intravenously over one minute. Prior to study, CAR was assessed. Monitoring included MAP, HR, SaO2, ETCO2, SjO2 and ICP. Changes in cerebral blood flow (CBF) were estimated from relative changes in AVDO2. Patients mean GCS was 5.7 +/- 1.7 (mean +/- STD) and mean ICP on admission was 23.8 +/- 16.3 mmHg. Fentanyl caused significant increases in ICP and decreases in MAP and CPP, but CBF remained unchanged when estimated by AVDO2. In patients with preserved CAR (34.5%), opioid-induced ICP increase was greater (but not statistically significant) than in those with impaired CAR (65.5%). We conclude than fentanyl moderately increased ICP and decreased MAP and CPP. Our data suggests that in patients with preserved CAR, potent opioids could cause greater increases of ICP, probably due to activation of the vasodilatadory cascade.
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PMID:Effects on intracranial pressure of fentanyl in severe head injured patients. 977 29