The Effects of Gammahydroxybutyrate and Sodium Thiopentone on Intracranial Pressure in Severe Head Injury

Abstract

Barbiturates have been used in the treatment of raised intracranial pressure (ICP) for more than 10 years (Shapiro et al. 1974; Miller 1979). Doubts have been expressed about their effectiveness. A recent prospective trial of barbiturate therapy versus mannitol therapy suggested that barbiturate therapy was not as effective as mannitol and had more deleterious side effects (Schwartz et al. 1984). More recently shorter acting anaesthetic agents have been advocated because of the side effects and long half-life of barbiturates. Two such drugs, Etomidate and Althesin, have recently been withdrawn from clinical use because of side effects.