Effect of Sevoflurane-Fentanyl Anesthesia on ICP in Patients undergoing Intracranial Surgery

Objective:To investigate the effect of sevoflurane-fentanyl anesthesia in patients undergoing intracranial surgery. Methods:Twenty-six ASAⅠtoⅡpatients(16male/10female,age 18-62 years)were scheduled for elective intracranial surgery (removal of hypophysoma).Anesthesia induction was provided by intravenous midazolam(0.1 mg·kg~(-1)),fentanyl(3μg·kg~(-1))、propofol(1-2 mg·kg~(-1))and vecuronium(0.1 mg·kg~(-1)).After endotracheal intubation anesthesia was maintained with inhalation of sevoflurane(1 MAC)throughout the operation.MAP,HR,SpO_2,cerebrospinal pressure(CSFP)and P_(ET) CO_2 were recorded before and during induction,at 10,30,45 and 60 min during sevoflurane inhalation.Results:CSFP and MAP were decreased significantly during anesthesia induction(P0.01).The CSFP tended to increase after inhalation of 1. 7% to 2%(1 MAC)sevoflurane,but remained below the baseline till 60 min.MAP was decreased following inhalation of 1 MAC sevoflurane and kept relatively stable thereafter.No significant difference was found in HR and SpO_2 throughout the study period.Conclusion:Under the condition of P_(ET)CO_2 from 30 to 35 mmHg,1 MAC sevoflurane anesthesia can be used safe- ly without any increase in ICP in patients undergoing intracranial surgery.