EFFECT OF ONDANSETRON ON INTRACRANIAL-PRE SSURE AND CEREBRAL PERFUSION-PRESSURE IN PATIENTS UNDERGOING NEUROSURGERY

Objective: To determine the effect of ondansetron on intracranial pres sure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressu re (CPP). Study design: Prospective, comparative, randomized double-bl ind study. Patients: Twenty-six patients undergoing intracranial surge ry. Method: Induction was obtained with propofol (1-2.5 mg . kg(-1)), fentanyl (1.5 mu g . kg(-1)) and pancuronium (0.1 mg . kg(-1)), and ma intenance was achieved with propofol and fentanyl. Intermittent positi ve pressure ventilation was used to ensure mild hypocapnia at 35 +/- 2 mmHg. Positioning of the patient was followed by 15 minutes steady-st ate. Patient received thereafter either 8 mg ondansetron or a placebo intravenously. The ICP was measured using a lumbar malleable spinal ne edle. CPP was calculated using the formula CCP = MAP-ICP. All variable s were measured every minute for 15 minutes. Results: The ICP, MAP and CPP did not differ between the two groups. There were no differences in the highest ICP values in patients receiving either ondansetron or placebo (11 +/- 5 versus 9 +/- 5, (X) over bar +/- SD), respectively. Conclusion: Intravenous administration of 8 mg ondansetron affects nei ther cerebral hemodynamics nor ICP. (C) 1998 Elsevier, Paris.