Abstract
In vitro studies suggest that the preservatives methylparaben and propylparaben included in some multidose vials of succinylcholine are the cerebral vasodilators responsible for the increases in intracranial pressure (ICP) documented after succinylcholine administration. To test this hypothesis, we measured cerebral blood flow (CBF) and cerebral blood flow velocity (CBFV) with inhaled133Xenon and transcranial Doppler respectively in healthy humans before and after the intravenous administration of methylparaben and propylparaben. We found no change in either CBF or CBFV after the paraben injections and therefore conclude that it is unlikely that the rise in ICP seen with succinylcholine is caused by cerebral arterial vasodilatation from the preservatives methylparaben and propylparaben.
Résumé
Certaines études in vitro suggèrent que les préservatifs méthylparabène et propylparabène seraient les vasodilatateurs cérébraux responsables de l’augmentation de la pression intracrânienne observée après l’administration de succinylcholine provenant de certains vials multidoses. Pour vérifier cette hypothèse, nous avons mesuré le flot sanguin cérébral et la vélocité du flot sanguin cérébral à l’aide de xénon 133 et du doppler transcrânien chez l’humain normal avant et après l’administration intra-veineuse de méthylparabène et de propylparabène. N’ayant observé aucun changement de flot sanguin cérébral ou de vélocité du flot sanguin cérébral après l’injection de ces substances, nous en concluons que les préservatifs méthylparabène et propylparabène ne sont pas responsables de la vasodilatation artérielle cérébrale et de l’augmentation de la pression intracrânienne observée après l’administration de succinylcholine.
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References
Cottrell JE, Hartung J, Giffin JP, Shwiry B. Intracranial and hemodynamic changes after succinylcholine administration in cats. Anesth Analg 1983; 62: 1006–9.
Lam AM, Gelb AW. Succinylcholine and intracranial pressure — a cause for “pause”. Anesth Analg 1984; 63: 619–25.
Miller RD, Savarese JJ. Pharmacology of muscle relaxants and their antagonists. In: Miller RD (Ed.)-Anesthesia, 3rd ed. New York: Churchill Livingstone, 1990.
Hamilton JT, Zhou Y, Gelb AW. Paraben preservatives but not succinylcholine are cerebral vasodilators in vitro. Anesthesiology 1990; 73: 1252–7.
Obrist WD, Wilkinson WE. Regional cerebral blood flow measurement in humans by xenon-133 clearance. Cerebrovascular and Brain Metabolism Review 1990; 2: 283–327.
Brandt L, Andersson KE, Hindfelt B, Ljunggren B, Pickard JD. Are the vascular effects of naloxone attributable to the preservatives methyland propylparaben? J Cerebr Blood Flow Metab 1983; 3: 395–8.
Waters A, Harder DR. Electromechanical coupling in rat basilar artery in response to morphine. Neurosurgery 1973; 13: 676–80.
Lanier WL, Milde JH, Michenfelder JD. Cerebral stimulation following succinylcholine in dogs. Anesthesiology 1986; 64: 551–9.
Ewing JR, Robertson WM, Brown GG, Welch KMA.133Xenon inhalation: accuracy in detection of ischemic cerebral regions and angiographic lesions. In: Wood JH (Ed.). Cerebral Blood Flow: Physiologic and Clinical Aspects. New York, McGraw-Hill Book Company, 1987: 202–19.
Aaslid R, Markwalder T-M, Nornes H. Noninvasive transcranial doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 1982; 57: 769–74.
Taylor GA, Short BL, Walker LK, Traystman RJ. Intracranial blood flow: quantification with duplex doppler and color doppler flow US1. Radiology 1990; 176: 231–6.
Bishop CCR, Powell S, Rutt D, Browse N. Transcranial doppler measurement of middle cerebral artery blood flow velocity: a validation study. Stroke 1986; 17: 913–5.
Pompy L, Karlin A, Capuano CM, Cottrell JE, Hartung J. Paraben preservatives do not increase intracranial pressure in cats. Anesthesiology 1991; 75: 669–72.
Jones PS, Thigpen D, Morrison JL, Richardson AP. p-Hydroxybenzoic acid esters as preservatives III. Journal of the American Pharmaceutical Association 1956; XLV: 268–73.
Tomita M. Significance of cerebral blood volume. In: Tomita M, Sawada T, Naritomi H, Heiss W-D (Eds.). Cerebral Hyperemia and Ischemia: From the Standpoint of Cerebral Blood Volume. Amsterdam. Elsevier Science Publishers, 1988:3–31.
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Gelb, A.W., Gignac, E., Manninen, P.H. et al. Methylparaben and propylparaben do not alter cerebral blood flow in humans. Can J Anaesth 39, 691–694 (1992). https://doi.org/10.1007/BF03008232
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DOI: https://doi.org/10.1007/BF03008232