Effect of propofol on brain retraction pressure and cerebral perfusion pressure

Abstract

We have studied the effect of propofol, at a rate of 30 mg kg-1 h-1 for 5 min reducing to 6 mg kg-1 h-1 for a further 5 min, on brain retraction pressure (BRP) in 15 patients undergoing craniotomy. The response of BRP showed two distinct patterns. BRP was reduced by an average of 3.3 mm Hg (P = 0.005). Mean arterial pressure was reduced in all patients by an average maximum of 28.3 mm Hg (P < 0.001), which caused a significant reduction in cerebral perfusion pressure (CPP) by 22.9 mm Hg (P < 0.001). It is concluded that, by reducing BRP, propofol provided suitable conditions for intracranial surgery, but care should be taken to avoid excessive reduction in CPP. © 1990 Copyright: 1990 British Journal of Anaesthesia.