Authors: Lescot, Thomas¹; Pereira, Ana¹; Abdennour, Lamine¹; Sanchez-Pena, Paola¹; Naccache, Lionel²; Coriat, Pierre¹; Puybasset, Louis³

Source: Neurocritical Care, Volume 7, Number 2, October 2007 , pp. 124-127(4)

Publisher: Humana Press

Abstract:

Delirium is a frequent complication of traumatic brain injury, especially during the weaning period. Antipsychotic drugs are often used in this case. Loxapine is a tricyclic antipsychotic drug with sedating properties. The effects of intravenous loxapine on EEG as well as on systemic and cerebral hemodynamics after traumatic brain injury are unknown.

Seven sedated and mechanically ventilated traumatic brain injured patients were studied 11 ± 5 days after trauma. They were on continuous perfusion of sufentanil and midazolam. Left and right spectral edge frequency (SEFl, SEFr) of continuous EEG recording, intracranial pressure (ICP), mean flow velocity of the middle cerebral artery (MFV_MCA) and mean arterial pressure (MAP) were simultaneously recorded and digitalized before and after loxapine infusion (10 mg in 10 min of continuous infusion).

Loxapine induced no significant change on MAP, MFV. On the contrary, it decreased ICP and both SEFl, SEFr. ETCO₂ and the dose of vasopressors were not altered during the study period.

10 mg of loxapine administered intravenously over 10 min decreased brain electrical activity. There is a concomitant reduction in ICP without any significant change in cerebral blood flow velocity. The use of intravenous loxapine to control agitation is not accompanied by deleterious hemodynamic or systemic effects in ICU's traumatic brain injured patients.

Keywords: Traumatic brain injury; Delirium; Loxapine; Agitation; Antipsychotics; Continuous electroencephalogram monitoring; Intracranial pressure

Document Type: Research article

DOI: http://dx.doi.org/10.1007/s12028-007-0051-7

Affiliations: 1: Department of Anesthesiology and Critical Care, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie-Paris 6, Paris, France, 2: Clinical Neurophysiology Department, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP),Université Pierre et Marie Curie-Paris 6, Paris, France, 3: Department of Anesthesiology and Critical Care, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie-Paris 6, Paris, France, Email: louis.puybasset@psl.aphp.fr

Publication date: 2007-10-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Neurology & Psychiatry
• By this author: Lescot, Thomas ;  Pereira, Ana ;  Abdennour, Lamine ;  Sanchez-Pena, Paola ;  Naccache, Lionel ;  Coriat, Pierre ;  Puybasset, Louis

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers