Intracranial pressure during nitroglycerin-induced hypotension

J. E. Cottrell, B. Gupta, H. Rappaport, H. Turndorf, J. Ransohoff, E. S. Flamm

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Abstract

Nitroglycerin was given intravenously to 5 anesthetized, hyperventilated (PaCO2 25 to 30 torr) patients during craniotomy, to facilitate surgery by creating a relatively bloodless field, and to decrease the potential need for blood transfusion. A subarachnoid screw and an indwelling radial artery catheter were inserted to monitor intracranial pressure (ICP) and mean arterial pressure (MAP). As MAP decreased from 104.4 ± 4.0 (SE) to 69.0 ± 1.8 torr, ICP increased from 14.2 ± 0.7 (SEM) to 30.8 ± 1.1 torr. Cerebral perfusion pressure decreased from 90.2 ± 3.6 (SEM) to 38.2 ± 2.3 torr (p < 0.0005). The authors attribute this nitroglycerin-induced ICP increase to capacitance vessel dilation within the relatively noncompliant cranial cavity, with subsequent cerebral blood volume increase.

Original languageEnglish (US)
Pages (from-to)309-311
Number of pages3
JournalJournal of neurosurgery
Volume53
Issue number3
DOIs
StatePublished - Jan 1 1980
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Cottrell, J. E., Gupta, B., Rappaport, H., Turndorf, H., Ransohoff, J., & Flamm, E. S. (1980). Intracranial pressure during nitroglycerin-induced hypotension. Journal of neurosurgery, 53(3), 309-311. https://doi.org/10.3171/jns.1980.53.3.0309