Blood pressure changes in head-injury patients during pre-hospital anaesthesia with propofol
Intubation at the site of accident is often necessary for patients who have sustained significant head injuries. Propofol can attenuate the hypertensive response to intubation, and cause hypotension in anaesthetic doses which can be greatly exaggerated in hypovolaemic patients. We studied nine patie...
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| Veröffentlicht in: | Injury 1994, Vol.25, p.SB7-SB8 |
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| container_title | Injury |
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| creator | Heath, K.J. Samra, G.S. Davis, G.E. Wilmink, A.B. Wilson, A.W. |
| description | Intubation at the site of accident is often necessary for patients who have sustained significant head injuries. Propofol can attenuate the hypertensive response to intubation, and cause hypotension in anaesthetic doses which can be greatly exaggerated in hypovolaemic patients. We studied nine patients with isolated head injuries and 11 multiply injured patients with associated head injuries. Patients were resuscitated and then intubated with a small dose of propofol, titrated to ensure unconciousness, and then suxamethonium. In neither group was there a statistically significant fall in blood pressure afterwards although the multiply injured patients tended have greater falls. We conclude that propofol used thus does not cause clinically important hypotension in these potentially unstable patients, but only doctors with suitable anaesthetic and pre-hospital experience should attempt it. |
| doi_str_mv | 10.1016/0020-1383(94)90193-7 |
| format | Article |
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Propofol can attenuate the hypertensive response to intubation, and cause hypotension in anaesthetic doses which can be greatly exaggerated in hypovolaemic patients. We studied nine patients with isolated head injuries and 11 multiply injured patients with associated head injuries. Patients were resuscitated and then intubated with a small dose of propofol, titrated to ensure unconciousness, and then suxamethonium. In neither group was there a statistically significant fall in blood pressure afterwards although the multiply injured patients tended have greater falls. We conclude that propofol used thus does not cause clinically important hypotension in these potentially unstable patients, but only doctors with suitable anaesthetic and pre-hospital experience should attempt it.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/0020-1383(94)90193-7</identifier><identifier>PMID: 7960080</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Blood Pressure - drug effects ; Craniocerebral Trauma - therapy ; Emergency Medical Services ; Humans ; Intubation, Intratracheal ; Multiple Trauma - therapy ; Propofol ; Succinylcholine</subject><ispartof>Injury, 1994, Vol.25, p.SB7-SB8</ispartof><rights>1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c221t-3b122d6761641f7d688cef6d70b999876c160f8c23fd80dc97b712acf0ba3c643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/0020138394901937$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7960080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heath, K.J.</creatorcontrib><creatorcontrib>Samra, G.S.</creatorcontrib><creatorcontrib>Davis, G.E.</creatorcontrib><creatorcontrib>Wilmink, A.B.</creatorcontrib><creatorcontrib>Wilson, A.W.</creatorcontrib><title>Blood pressure changes in head-injury patients during pre-hospital anaesthesia with propofol</title><title>Injury</title><addtitle>Injury</addtitle><description>Intubation at the site of accident is often necessary for patients who have sustained significant head injuries. Propofol can attenuate the hypertensive response to intubation, and cause hypotension in anaesthetic doses which can be greatly exaggerated in hypovolaemic patients. We studied nine patients with isolated head injuries and 11 multiply injured patients with associated head injuries. Patients were resuscitated and then intubated with a small dose of propofol, titrated to ensure unconciousness, and then suxamethonium. In neither group was there a statistically significant fall in blood pressure afterwards although the multiply injured patients tended have greater falls. We conclude that propofol used thus does not cause clinically important hypotension in these potentially unstable patients, but only doctors with suitable anaesthetic and pre-hospital experience should attempt it.</description><subject>Blood Pressure - drug effects</subject><subject>Craniocerebral Trauma - therapy</subject><subject>Emergency Medical Services</subject><subject>Humans</subject><subject>Intubation, Intratracheal</subject><subject>Multiple Trauma - therapy</subject><subject>Propofol</subject><subject>Succinylcholine</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLxDAQx4Mouj6-gUJPoofqpKl5XAQVXyB40ZsQ0mRqI92mJq3it7frLnv0NIf_Y2Z-hBxSOKNA-TlAATllkp2o8lQBVSwXG2RGpVA5FFxsktnaskN2U_oAoAIY2ybbQnEACTPydt2G4LI-YkpjxMw2pnvHlPkua9C43HcfY_zJejN47IaUuTH67n3hz5uQej-YNjOdwTQ0mLzJvv3QTGroQx3afbJVmzbhwWrukde725ebh_zp-f7x5uopt0VBh5xVtCgcF5zyktbCcSkt1twJqJRSUnBLOdTSFqx2EpxVohK0MLaGyjDLS7ZHjpe90-LPcbpFz32y2LamwzAmLbik6oLDZCyXRhtDShFr3Uc_N_FHU9ALqHpBTC-IaVXqP6haTLGjVf9YzdGtQyuKk3651HF68stj1MlOuCw6H9EO2gX__4JfOA6HHA</recordid><startdate>1994</startdate><enddate>1994</enddate><creator>Heath, K.J.</creator><creator>Samra, G.S.</creator><creator>Davis, G.E.</creator><creator>Wilmink, A.B.</creator><creator>Wilson, A.W.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1994</creationdate><title>Blood pressure changes in head-injury patients during pre-hospital anaesthesia with propofol</title><author>Heath, K.J. ; Samra, G.S. ; Davis, G.E. ; Wilmink, A.B. ; Wilson, A.W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c221t-3b122d6761641f7d688cef6d70b999876c160f8c23fd80dc97b712acf0ba3c643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Blood Pressure - drug effects</topic><topic>Craniocerebral Trauma - therapy</topic><topic>Emergency Medical Services</topic><topic>Humans</topic><topic>Intubation, Intratracheal</topic><topic>Multiple Trauma - therapy</topic><topic>Propofol</topic><topic>Succinylcholine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heath, K.J.</creatorcontrib><creatorcontrib>Samra, G.S.</creatorcontrib><creatorcontrib>Davis, G.E.</creatorcontrib><creatorcontrib>Wilmink, A.B.</creatorcontrib><creatorcontrib>Wilson, A.W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heath, K.J.</au><au>Samra, G.S.</au><au>Davis, G.E.</au><au>Wilmink, A.B.</au><au>Wilson, A.W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood pressure changes in head-injury patients during pre-hospital anaesthesia with propofol</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>1994</date><risdate>1994</risdate><volume>25</volume><spage>SB7</spage><epage>SB8</epage><pages>SB7-SB8</pages><issn>0020-1383</issn><eissn>1879-0267</eissn><abstract>Intubation at the site of accident is often necessary for patients who have sustained significant head injuries. Propofol can attenuate the hypertensive response to intubation, and cause hypotension in anaesthetic doses which can be greatly exaggerated in hypovolaemic patients. We studied nine patients with isolated head injuries and 11 multiply injured patients with associated head injuries. Patients were resuscitated and then intubated with a small dose of propofol, titrated to ensure unconciousness, and then suxamethonium. In neither group was there a statistically significant fall in blood pressure afterwards although the multiply injured patients tended have greater falls. We conclude that propofol used thus does not cause clinically important hypotension in these potentially unstable patients, but only doctors with suitable anaesthetic and pre-hospital experience should attempt it.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>7960080</pmid><doi>10.1016/0020-1383(94)90193-7</doi></addata></record> |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Blood Pressure - drug effects Craniocerebral Trauma - therapy Emergency Medical Services Humans Intubation, Intratracheal Multiple Trauma - therapy Propofol Succinylcholine |
| title | Blood pressure changes in head-injury patients during pre-hospital anaesthesia with propofol |
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