Intracranial pressure after atracurium in neurosurgical patients. Anesth Analg 1985;64:1113-6. In order to investigate the usefiilness of atraciiriurn for murosurgical anesthesia, W K studied its impact on intracranial pressure (subarachnoid bolt) mean arterial pressure (radial artery catheter) and cerebral perfusion pressure (mean arterial pressure-intracranial pressure) in 20 patients undergoing electizv craniotomy for brain tumor excision. General aimthesin was induced with tiriopental, 4 mglkg intrauenously, and maintained with 70 percent nitrous oxide in oxygen. Ventilation was controlled by face mask, uiith end-tidal C 0 2 held constant. Once intracranial pressure arid mean arterial pressure had stabilized, the response to atracurium, 0.5 mglkg intravenozisly, zoas corrtinuonsly recorded for 5 niin in 10 patients. An additional 10 patients receizJed no atracurium and served as matched controls. Thiopenta[ caused reductions in IcP in both g r o u p of patients. Cornparing the responses ofthe patients who receiwd atracurii~ni with those zoho did riot, we found that atmcurium had no significant effect on irrtracraninl pressnrt~, mean arterial pressure or cerebral perfusion pressure. Based on these data w e conclude that atracurium appears to be preferable to the other aoailable neuroniuscular blocking agents that h a w been evaluated for neurosurgical anesthesia.
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