Effects of conversation on intracranial pressure in comatose patients.

In this time series design study we investigated the effects of conversation on intracranial pressure (ICP). Two conversation types were used, and continuous measurements of ICP were recorded. Type 1 conversation was an emotionally referenced conversation that reflected an actual nursing report on the patient's current condition. Type 2 conversation was a predetermined dialogue unrelated to the patient. Two hypotheses were tested to determine the existence of differences between the ICP measurements at baseline and the ICP measurements during any conversation, and differences between the ICP measurements recorded during type 1 conversation and during type 2 conversation. Eight subjects served as their own control. T tests were performed between the mean scores of the minimum, maximum, and average ICP measurements before, during, and after both conversations. The hypotheses were not supported by the findings. There was, however, a statistically significant decrease in ICP when minimum ICP measurements before type 2 conversations were compared with measurements recorded during type 2 conversation. The data also demonstrated a wide variation of individual patient responses. The results of the current study suggest that the direction of influence from conversation on the ICP is individual and may be influenced greatly by the patient's level of consciousness.