Intracranial pressure during nifedipine-induced hypotension.

The effect of nifedipine-induced hypotension on intracranial pressure (ICP) was investigated in cats with normal and artificially increased ICP. Eleven cats were anesthetized with intraperitoneal pentobarbital (25 mg/kg), intubated, and ventilated with nitrous oxide in oxygen. Mean arterial pressure (MAP), heart rate (HR), and mean pulmonary artery pressure (PAP) were continuously recorded. A double 19-gauge needle was inserted into the cisterna magna; ICP was continuously monitored from one needle and the other was used to increase and maintain ICP at 27 +/- 4 mm Hg by infusion of pH-adjusted Ringer's lactate solution. After control measurements were taken, nifedipine was given intravenously in each cat when ICP was normal and increased. Infusion of 96 +/- 12 micrograms (SEM) nifedipine (approximately equal to 33 micrograms/kg) reduced MAP 35-45% for 2.5 +/- 0.8 min when ICP was normal, and for 2.0 +/- 0.6 min when ICP had been increased. When initial ICP was normal, nifedipine-induced hypotension produced a small (2.2 mm Hg) but statistically significant increase in ICP and decrease in cerebral perfusion pressure (P less than 0.01). When ICP was initially elevated, nifedipine-induced hypotension produced a larger increase in ICP (5 +/- 1 mm Hg) and a proportionately larger decrease in cerebral perfusion pressure (P less than 0.01).