Document Detail

Effects of niravoline (RU 51599), a selective kappa-opioid receptor agonist on intracranial pressure in gradually expanding extradural mass lesion.
MedLine Citation:
PMID:  9512087     Owner:  NLM     Status:  MEDLINE    
It has recently been reported that kappa-opioid receptor agonists inhibit antidiuretic hormone secretion and promote water excretion in humans and animals. We investigated the effect of niravoline (RU 51599), a selective kappa-opioid receptor agonist in the treatment of intracranial hypertension. Acute intracranial hypertension was induced in cats by continuous inflation of an extradural balloon with physiological saline at the constant rate of 0.5 ml/h for 3 h. At this point, inflation was discontinued and the balloon remained expanded for an additional hour after which it was deflated. In the post-deflation period, monitoring continued for 1 h. The control group (n = 8) received ringer's lactate solution only, while the treatment group (n = 8) received an intravenous (IV) injection of 1.0 mg/kg of niravoline, every hour at the beginning of balloon inflation, during balloon inflation, in post-inflation, and at deflation time (5 doses). Changes in intracranial pressure (ICP), mean arterial blood pressure (MAP), cerebral perfusion pressure (CPP), electroencephalogram (EEG), blood gases, pupil size, serum electrolytes, and osmolality were measured in both groups. Brain water content was determined in a separate group of cats at the end of a 3-h extradural brain compression. Compared to the untreated group, the niravoline-treated group had a significantly lower ICP and higher CPP at the 2 and 3 h during balloon inflation, in post-inflation, and in post-deflation periods. Brain water content was significantly reduced in niravoline-treated animals. No significant change was observed in serum osmolality throughout the experiment. Our results indicate that the mechanism by which niravoline reduces ICP is partly via a reduction in brain water content. Also, the current findings suggest that in clinical situations in which ICP is elevated due to the pressure of an extradural mass, niravoline may effectively reduce ICP while maintaining adequate CPP until the mass is removed.
I Bemana; S Nagao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurotrauma     Volume:  15     ISSN:  0897-7151     ISO Abbreviation:  J. Neurotrauma     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-05-08     Completed Date:  1998-05-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  117-24     Citation Subset:  IM    
Department of Neurological Surgery, Kagawa Medical University, Japan.
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MeSH Terms
Blood Pressure / drug effects,  physiology
Brain Injuries / pathology,  physiopathology*
Cerebrovascular Circulation / drug effects,  physiology
Intracranial Pressure / drug effects*
Pyrrolidines / pharmacology*
Receptors, Opioid, kappa / agonists*
Reg. No./Substance:
0/Benzeneacetamides; 0/Pyrrolidines; 0/Receptors, Opioid, kappa; 130610-93-4/niravoline

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