A patient with subdural hematoma have to undergo elbow surgery, best anesthetic agent among following is –
Correct Answer: Thiopentone
Description: Ans. is 'c' i.e., Thiopentoneo Patient with subdural hematoma already has increased intracranial tension. All these agents except thiopentone will further increase intracranial tension. Thiopentone decreases intracranial tension.Neurophysiology and anesthesiao All intravenous inducing agents except for ketamine (i.e., etomidate, thiopentone, methohexitone and propofol) decrease cerebral metabolic rate, cerebral blood flow, and intracranial tension. The maximum decrease in cerebral blood flow and cerebral protection is caused by thiopentone - IV agent of choice for neurosurgery.o Ketamine increases cerebral metabolic rate, cerebral blood flow and intracranial tension . Inhalational agentso All inhalational agents :i) Increase intracranial tension and cerebral blood flow.ii) Decrease cerebral metabolic rate There by provide cerebroprotection.o Amongst inhalational agents, isofluraneprovides maximum cerebroprotection, therefore it is the inhalational agent of choice for neurosurgery.Lidocaineo Lidocaine decreases ICT, Cerebral blood flow and metabolic rate.
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