TY - JOUR
T1 - Adverse impact of a calcium entry-blocker (verapamil) on intracranial pressure in patients with brain tumors
AU - Bedford, R. F.
AU - Dacey, R.
AU - Winn, H. R.
AU - Lynch, C. L.
PY - 1983
Y1 - 1983
N2 - In order to examine the effects of verapamil on intracranial pressure (ICP) in patients with compromised intracranial compliance, five hypertensive patients with supratentorial tumors were given verapamil, 5 mg intravenously, at the time of anesthesia induction. Within 4 minutes, ICP increased 67% from 18 ± 4 mm Hg (standard error) to 27 ± 5 mm Hg (p < 0.05), whereas mean arterial pressure decreased 20% from 111 ± 7 mm Hg to 89 ± 4 mm Hg (p < 0.05), and cerebral perfusion pressure (CPP) decreased 33% from 93 ± 11 mm Hg to 62 ± 6 mm Hg (p < 0.05). The increases in ICP responded promptly to hyperventilation and intravenous lidocaine (1.5 mg/kg). A control group of five hypertensive patients with supratentorial tumors received the same anesthetic agents without verapamil. In this group, ICP and CPP were unchanged. The authors conclude that calcium entry-blockers, such as verapamil, should be avoided in patients with compromised intracranial compliance unless ICP is being monitored and proper therapy for intracranial hypertension can be rapidly instituted.
AB - In order to examine the effects of verapamil on intracranial pressure (ICP) in patients with compromised intracranial compliance, five hypertensive patients with supratentorial tumors were given verapamil, 5 mg intravenously, at the time of anesthesia induction. Within 4 minutes, ICP increased 67% from 18 ± 4 mm Hg (standard error) to 27 ± 5 mm Hg (p < 0.05), whereas mean arterial pressure decreased 20% from 111 ± 7 mm Hg to 89 ± 4 mm Hg (p < 0.05), and cerebral perfusion pressure (CPP) decreased 33% from 93 ± 11 mm Hg to 62 ± 6 mm Hg (p < 0.05). The increases in ICP responded promptly to hyperventilation and intravenous lidocaine (1.5 mg/kg). A control group of five hypertensive patients with supratentorial tumors received the same anesthetic agents without verapamil. In this group, ICP and CPP were unchanged. The authors conclude that calcium entry-blockers, such as verapamil, should be avoided in patients with compromised intracranial compliance unless ICP is being monitored and proper therapy for intracranial hypertension can be rapidly instituted.
UR - http://www.scopus.com/inward/record.url?scp=0020618708&partnerID=8YFLogxK
U2 - 10.3171/jns.1983.59.5.0800
DO - 10.3171/jns.1983.59.5.0800
M3 - Article
C2 - 6619931
AN - SCOPUS:0020618708
SN - 0022-3085
VL - 59
SP - 800
EP - 802
JO - Journal of neurosurgery
JF - Journal of neurosurgery
IS - 5
ER -