Intracranial pressure after phenoperidine

The problem of sedating patients requiring prolonged controlled ventilation has recently received considerable attention. Various therapeutic regimes are available and there appears to be a general move away from the use of muscle relaxants towards sedative drugs. Phenoperidine is a popular agent for this purpose. One survey from a district general hospital reported that 66% of their ventilated intensive therapy unit patients received phenoperidine, either alone or as part of a sedation regime. However, enthusiasm for its use must be tempered by recent reports of cardiovascular collapse following its administration. We wish to report a case of intracranial hypertension following the use of phenoperidine in a ventilated patient with a severe head injury.