OPIOID SEDATION DOES NOT ALTER INTRACRANIAL-PRESSURE IN HEAD-INJURED PATIENTS

Purpose: This study aimed to examine the effects of sedative doses of morphine, fentanyl and sufentanil on intracranial pressure (ICP) in he ad-injured patients in whom changes in mean arterial pressure (MAP) we re minimized. Methods: Fifteen severely head-injured patients (SSC of less than or equal to 8) were randomly assigned to receive either fent anyl, sufentanil or morphine, titrating the drug to a maximal 10% decr ease in MAP. The patients were subsequently given an infusion of the s ame opioid. For four hours, ICF: MAP and heart rate were recorded. Res ults: In all groups, there were no increases in ICP. There was a decre ase in MAP in the sufentanil group at 10 min (P < 0.05) and 45 min aft er the initial opioid bolus. These decreases in MAP were not associate d with increases in ICP. Conclusion: The study suggests that when opio ids are titrated in head-injured patients, worsening intracranial pres sure can be avoided.