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• W2006752908 abstract "Objectives To determine the effects of bolus injection and infusion of sufentanil, alfentanil, and fentanyl on cerebral hemodynamics and electroencephalogram activity in patients with increased intracranial pressure (ICP) after severe head trauma. Design Randomized, unblended, crossover study. Setting Intensive care unit and trauma center in a university hospital. Patients Six patients with head trauma and ICP monitoring, sedated at the time of the study with propofol infusion and full neuromuscular blockade. Interventions Following a randomized order, in an unblended and crossover fashion, the level of sedation was deepened with a 6-min injection of either sufentanil (1 [micro sign]g/kg), alfentanil (100 [micro sign]g/kg), or fentanyl (10 [micro sign]g/kg) followed by an infusion of 0.005, 0.7, and 0.075 [micro sign]g/kg/min, respectively, for 1 hr. The three opioids were given to each patient at 24-hr intervals. Measurements and Main Results Mean arterial pressure (MAP), ICP, cerebral perfusion pressure (CPP), and jugular vein bulb oxygen saturation (SvjO2) were continuously measured and recorded at 1-min intervals throughout the 60-min study period. Sufentanil, fentanyl, and alfentanil infusions were associated with a significant but transient increase in ICP (9 +/- 2 mm Hg [SD], 8 +/- 2 mm Hg, and 5.5 +/- 1 mm Hg, respectively; p < .05). The increase in ICP peaked at 5, 6, and 3 mins, respectively, then gradually decreased and returned to baseline values after 15 mins. This result was accompanied by a significant decrease in MAP (21 +/- 2 mm Hg, 24 +/- 2 mm Hg, and 26 +/- 2 mm Hg, respectively; p < .05) and, thus, in CPP (30 +/- 3 mm Hg, 31 +/- 3 mm Hg, and 34 +/- 3 mm Hg, respectively; p < .05). After 5 mins, MAP and CPP gradually increased, although they remained significantly decreased throughout the study period. No changes in lactate-oxygen index, used as an ischemia index, were observed. Changes in electroencephalogram tracings were characterized by a switch from a fast to a decreased activity, together with an improvement in the background activity. Conclusion The results of the present study show that alfentanil, sufentanil, and fentanyl produce similar transient increases in ICP when administered by bolus injection in patients with increased ICP. No evidence of cerebral ischemia was observed in the study patients. (Crit Care Med 1999; 27:407-411)" @default.
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• W2006752908 date "1999-02-01" @default.
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• W2006752908 title "Sufentanil, fentanyl, and alfentanil in head trauma patients" @default.
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• W2006752908 doi "https://doi.org/10.1097/00003246-199902000-00050" @default.
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