Influence of bolus doses of phenoperidine on intracranial pressure and systemic arterial pressure in traumatic coma

Abstract

The effects of bolus doses of phenoperidine 1-2 mg i. v. either alone, or combined with pancuronium 2-4 mg, were investigated in seven patients in traumatic coma. Phenoperidine alone significantly reduced mean arterial pressure (MAP) by a mean (±SEM) of 13.2(±2.8) mm Hg. Overall there was no significant change in intracraniaI pressure (ICP) despite the decreases in MAP and, consequently, cerebral per-fusion pressure (CPP) decreased (14.0±2.4 mm Hg) on all but one occasion. In some instances these decreases were considerable (maximum 38 mm Hg). Similar results were obtained when phenoperidine was combined with pancuronium. These findings suggest that the bolus administration of phenoperidine and probably other opiates should be avoided in traumatic coma. © 1987 British Journal of Anaesthesia.