Sufentanil decreases cerebral blood flow velocity in patients with elevated intracranial pressure

Recent investigations revealed that sufentanil increases cerebral blood flow (CBF) and intracranial pressure (ICP) in dogs and man. The aim of our study was to evaluate the impact of sufentanil on cerebral blood flow velocity and ICP in neurosurgical patients. Eight neurosurgical ICU patients with elevated ICP (> 20 mmHg) were examined. Sufentanil was given in incremental doses of 0.5, 1.0 and 2.0 micrograms kg-1. Cerebral blood flow velocity decreased significantly from 54 +/- 4 cm s-1 to 48 +/- 3 cm s-1 with the dose of 1.0 microgram kg-1 sufentanil and 47 +/- 3 cm s-1 with 2.0 micrograms kg-1, respectively (mean +/- SEM). ICP values did not increase with any of the doses studied. Thus, changes of mean arterial pressure which fell with 1.0 microgram kg-1 and 2.0 micrograms kg-1 reflect cerebral perfusion pressure alterations. Although changes of cerebral blood flow velocity revealed changes in vascular tone, ICP remained unaltered.