Effects of sufentanil or ketamine administered in target-controlled infusion on the cerebral hemodynamics of severely brain-injured patients*

Bourgoin, A; Albanèse, Jacques; Léone, Marc; Sampol-Manos, Emmanuelle; Viviand, X.; Martin, Claude

doi:10.1097/01.ccm.0000162491.26292.98

Cited by 113 publications

(90 citation statements)

References 30 publications

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“…Two double-blind, randomized, controlled trials compared the effect of prolonged ketamine and sufentanil infusions in the ICU in patients with severe traumatic brain injury postcraniotomy. 19,20 These studies found no differences in mean daily intracranial or cerebral perfusion pressures. Schmittner et al 24 compared the effect of ketamine and fentanyl in patients with severe traumatic brain injuries or aneurysmal subarachnoid hemorrhages and found no significant differences in mean daily intracranial or cerebral perfusion pressures.…”

Section: Resultsmentioning

confidence: 95%

“…We reviewed the full texts of 192 articles, of which 10 met inclusion criteria. [18][19][20][21][22][23][24][25][26][27] Five randomized trials reported data on 854 patients, [19][20][21]24,25 and 5 prospective controlled studies reported data on 99 patients. 18,22,23,26,27 Tables 1 and 2 CPP, cerebral perfusion pressure.…”

Section: Characteristics Of Retrieved Studiesmentioning

confidence: 99%

“…21,25 All trials were deemed to be at low risk of detection bias for the outcomes of intracranial and cerebral perfusion pressures, ICU length of stay, and mortality despite inadequate blinding because these measures are objective and easily quantifiable. [19][20][21]24,25 Three trials reported the results of neuropsychometric tests and GCS score as secondary outcomes. 20,21,25 These outcomes were deemed to be at high risk of detection bias in the nonblinded trials because of the subjective nature of interpreting the scales.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Ketamine on Intracranial and Cerebral Perfusion Pressure and Health Outcomes: A Systematic Review

Cohen¹,

Athaide²,

Wickham³

et al. 2015

Annals of Emergency Medicine

168

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Section: Resultsmentioning

confidence: 95%

Section: Characteristics Of Retrieved Studiesmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Ketamine on Intracranial and Cerebral Perfusion Pressure and Health Outcomes: A Systematic Review

Cohen¹,

Athaide²,

Wickham³

et al. 2015

Annals of Emergency Medicine

168

View full text Add to dashboard Cite

“…Pentobarbital is a GABA agonist, and then the increase in ICP caused by ketamine can be blocked by the use of pentobarbital. In addition, ketamine did not involve a significant change for ICP of severely brain-injured patients [43]. In this study, MCAO site brain could have been severely injured and ketamine may not have increased ICP.…”

Section: Discussionmentioning

confidence: 96%

Inhibition of Neuron-Specific CREB Dephosphorylation is Involved in Propofol and Ketamine-Induced Neuroprotection Against Cerebral Ischemic Injuries of Mice

Luo-wa

Han

et al. 2011

Neurochem Res

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Propofol and ketamine may provide certain degree of neuroprotection, but the underlying mechanism remains unclear to date. The cAMP response element-binding protein (CREB) was proposed that its phosphorylation at Ser133 (P-CREB) constituted a convergence point involved in neuroprotection. The purpose of this study was to determine whether different dosages of propofol and ketamine could provide neuroprotection against permanent middle cerebral artery occlusion (MCAO)-induced ischemic injuries and the involvement of P-CREB. Eighty adult male BALB/c mice that underwent 6 h MCAO were randomly divided into eight groups: Sham-operation; MCAO + saline; MCAO + 25, 50, 100 mg/kg propofol; and MCAO + 25, 50, 100 mg/kg ketamine (intraperitoneal injection 30 min following MCAO). We found that 50, 100 (not 25) mg/kg propofol, and 25 (not 50 and 100) mg/kg ketamine could significantly reduce the infarct volume, edema ratio and neurological deficit (n = 10 per group) as well as inhibit the decrease of P-CREB level in peri-infarct region when compared with that of MCAO + saline group (n = 6 per group). In addition, the results of double-labeled immunofluorescent staining showed that P-CREB co-localized with neuron-specific marker, NeuN, in the peri-infarct region of 50 mg/kg propofol and 25 mg/kg ketamine treated 6 h MCAO mice (n = 4 per group). These results suggested that inhibition of neuron-specific P-CREB dephosphorylation in the peri-infarct region is involved in high dose propofol and low dose ketamine-induced neuroprotection of 6 h MCAO mice.

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“…In a more recent randomized study, ketamine-midazolam and sufentanil-midazolam were compared as target controlled infusions and ketamine was found to have no significant change on ICP or CPP [44]. In children, Bar-Joseph and colleagues performed a prospective study where ketamine was administered to control refractory intracranial hypertension.…”

Section: Usd Ketaminementioning

confidence: 98%

Management of Pediatric Traumatic Brain Injury

Mtaweh

Bell

2015

Curr Treat Options Neurol

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Pediatric severe traumatic brain injury continues to be a major cause of disability and death. Rapid initial airway and hemodynamic stabilization is critical, followed by the need for immediate recognition of intracranial pathology that requires neurosurgical intervention. Intracranial hypertension and cerebral hypoperfusion have been recognized as major insults after trauma and management should be directed at preventing both. Sedation with opioids, moderate hyperventilation to arterial carbon dioxide level of 35-40 mmHg, hyperosmolar therapy with 3 % saline or mannitol, normothermia, and cerebrospinal fluid drainage continue to be the cornerstones of initial management of intracranial hypertension (intracranial pressure >20 mmHg). Refractory intracranial hypertension is treated with high-dose barbiturate therapy to achieve medical burst suppression on electroencephalography and decompressive craniectomy. In addition, those children require antiepileptic medications for seizure prophylaxis, adequate nutritional management, and early physical therapy and rehabilitation referrals. Most of the evidence for care of children with brain injury comes from center-specific practice and experience rather than objective data. This lack of evidence provides the ground for ongoing research; nevertheless, outcomes after traumatic brain injury continue to show improvement.

show abstract

Effects of sufentanil or ketamine administered in target-controlled infusion on the cerebral hemodynamics of severely brain-injured patients*

Cited by 113 publications

References 30 publications

The Effect of Ketamine on Intracranial and Cerebral Perfusion Pressure and Health Outcomes: A Systematic Review

The Effect of Ketamine on Intracranial and Cerebral Perfusion Pressure and Health Outcomes: A Systematic Review

Inhibition of Neuron-Specific CREB Dephosphorylation is Involved in Propofol and Ketamine-Induced Neuroprotection Against Cerebral Ischemic Injuries of Mice

Management of Pediatric Traumatic Brain Injury

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