Alterations in ventricular fluid pressure during ketamine anesthesia in hydrocephalic children.

We studies ventricular fluid pressure changes in 26 hydrocephalic children following administration of ketamine. The increase in VFP previously found with intravenously administered ketamine was compared with changes after ketamine given intramuscularly, and the possible alteration of this increase with sedative premedicants was studies. Changing the route of administration did not change the time to peak VFP changes or the duration of pressure elevation. There was no demonstrable alteration of the increase in VFP by premedication with secobarbital, dorperidol, or diazepam in clinical dosage. We feel that acute rises of VFP may affect areas of marginal cerebral blood flow and may increase the risk of herniation of brain tissue.