[Intracranial pressure in patients with craniocerebral trauma after administration of propofol and thiopental].

Propofol (Disoprivan) is a rapid and effective hypnotic comparable with etomidate. Up to now, the effects on intracranial pressure (ICP) have only rarely been investigated, especially in cases with pre-existing increased ICP [4, 18]. The aim of this study was the evaluation of ICP after i.v. propofol administration in comparison with thiopental. Method. Five patients were studied, all of whom had had isolated head trauma. All were on controlled ventilation and were unconscious. Depending on the result of computer tomography, an epidural pressure transducer was implanted. ICP, blood pressure (BP), and heart rate (HR) were measured before and 1, 3, 5, 10, and 15 min after 1 mg/kg propofol; subsequently 2 mg/kg thiopental were administered and the same parameters documented. Cerebral perfusion pressure (CPP) and mean arterial pressure (MAP) were calculated. Results. ICP decreased in all five cases 5 min after the initial values were measured. Two patients showed an ICP decrease after thiopental. BP was reduced markedly by propofol and very slightly by thiopental. The CPP showed a small decrease in four patients after propofol and in two after thiopental. Conclusions. The data now available permit the conclusion that both propofol and thiopental can be used in patients with possibly elevated ICP. The marked cardiovascular side effects of propofol must be taken into consideration.