Neuroanesthesia

can cause CO2 retention leading to cerebral vasodilatation. All can cause muscle rigidity and some release histamine. The evidence concerning the effects of these drugs on cerebral hemo-dynamics and ICP is conflicting and depends on their cardiovascular effects as well as the background anesthetic.

The drugs act on specific opioid receptors and their effects can be reversed by specific antagonists. The drugs in this group differ in their onset and duration of action.

Shorter acting drugs fentanyl, alfentanil and sufentanil will allow rapid awakening at the end of the procedure. Remifentanil is an ultra-short-acting opioid. It is broken down in the plasma and can be given as an intravenous infusion [8]. Morphine and codeine are used for postoperative analgesia after neurosurgery.

Naloxone is a specific competitive antagonist that reverses the analgesia and respiratory depression caused by morphine and other opioids. It has no agonist activity. Its duration of action may be shorter than that of the opioid it is intended to reverse, and therefore repeated dosing may be necessary. Naloxone may have deleterious effects in neurosurgical patients, including increased CBF and cerebral metabolic rate (CMR), hypertension and rupture of intracranial aneurysms [9]. Naloxone has been shown to dramatically reverse the lateralizing deficits in patients with cerebral ischemia [10].

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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