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The influence of urapidil, an arylpiperazinederivate, on intracranial pressure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) was investigated in dogs with (group II) and without (group I) intracranial hypertension. After i.v. administration of urapidil, intracranial pressure remained unchanged and cerebral perfusion pressure decreased to the same extent as mean arterial pressure (20%). As in neurosurgical patients, autoregulation of cerebral blood flow is often lost; a sudden increase in blood pressure may lead to an increase in cerebral blood flow and to a damage of the blood bain barrier with consequent cerebral edema. Urapidil seems to be suitable for treating hypertensive episodes perioperatively in neurosurgical patients.

In neurosurgical patients autoregulation of cerebral perfusion is often lost. Therefore, a sudden increase in blood pressure may lead to an increase in cerebral blood flow and cerebral oedema may follow. The influence of labetalol, a new alpha- and beta-adrenoceptor blocking agent, on intracranial pressure and cerebral perfusion pressure was investigated in dogs without and with mass lesions. During hypotension with labetalol the intracranial pressure remained unchanged and the cerebral perfusion pressure decreased to the same extent as mean arterial pressure (30%). Labetalol seems to be suitable to treat hypertension perioperatively in neurosurgical patients but it is not a suitable drug for induced hypotension.

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