The use of propofol (Diprivan) for inducing anesthesia in neurosurgical patients. II. Its effect on intracranial pressure and on cerebral perfusion pressure

: Clinical study of the effect of propofol (diprivan) on intracranial and cerebral perfusion pressure (ICP and CPP, respectively) in 30 patients with neurosurgical diseases of the brain showed that propofol without narcotic analgesics did not block ICP increase in response to tracheal intubation. If it was combined with narcotic analgesics, the optimal combination was with pyritramide in a dose of 0.4 mg/kg, because this combination blocked ICP increase in response to laryngoscopy and tracheal intubation and did not appreciably decrease CPP. Propofol for decreasing acute intracranial hypertension (like bolus injection of thiopental) during surgery is unjustified, because during anesthesia, bolus injection of propofol just negligibly decreases ICP.