[Propofol in single bolus for treatment of elevated intracranial hypertension]

Eleven patients with intracranial pressure (ICP) above 20 mmHg despite hyperventilation and neurosedation were treated with a bolus of propofol (1.5 mg/kg) i.v. At baseline and 1-2-5-10-15-30-45 minutes after propofol administration we recorded the values of PIC, systolic arterial pressure (SAP) and mean arterial pressure (MAP), heart rate (HR) and cerebral perfusion pressure (CPP), calculated as MAP less PIC. In the first ten minutes after propofol we observed a statistically significant (p less than 0.05) decrease of ICP and SAP. MAP decreased in the first five minutes only. Consequently HR increased at the same time. CPP decreased in the first two minutes after administration of the drug, but without statistical evidence. We conclude that propofol, in our opinion, can be used to treat intracranial hypertension but the hemodynamic effects in hypovolemic patients must be taken into consideration.