PHARMACOKINETICS AND EFFECTS ON INTRACRANIAL-PRESSURE OF SUFENTANIL IN HEAD TRAUMA PATIENTS

Ten patients with head trauma received an intravenous bolus of sufenta nil (2 mu g kg(-1)) followed at 30 min by infusion of sufentanil (medi an 150 mu g h(-1)) and midazolam (median 9.0 mg h(-1)) over 48 h. Medi an (range) values of pharmacokinetic parameters for sufentanil were: t (1/2,z) = 16 (7-49) h; CL = 1215 (519-2550) ml min(-1); CLR = 7 f2-38) ml min(-1); V-ss = 10.0 (6.8-24,2)1 kg(-1). Decreases in intracranial pressure (ICP) (from 16.1 +/- 1.7 to 10.8 +/- 1.3 mm Hg; P < 0.05) an d mean arterial blood pressure (MAP) (from 85.5 +/- 3.9 to 80.2 +/- 4. 9 mm Hg; P < 0.05) were observed within 15 min of the bolus injection of sufentanil and remained unchanged thereafter. Thus, cerebral perfus ion pressure (CPP = MAP-ICP) was stable.