Which of the following anesthetic agents causes a rise in the Intracranial pressure
Correct Answer: Sevoflurane
Description: Sevoflurane's solubility in blood is slightly greater than desflurane (lb/g 0.65 versus 0.42). Nonpungency and rapid increases in alveolar anesthetic concentration make sevoflurane an excellent choice for smooth and rapid inhalation inductions in pediatric and adult patients. In fact, inhalation induction with 4% to 8% sevoflurane in a 50% mixture of nitrous oxide and oxygen can be achieved within 1 min. Likewise, its low blood solubility results in a rapid fall in alveolar anesthetic concentration upon discontinuation and a more rapid emergence compared with isoflurane. Similar to isoflurane and desflurane, sevoflurane causes slight increases in CBF and intracranial pressure at normocarbia, although some studies show a decrease in CBF. High concentrations of sevoflurane (>1.5 MAC) may impair the autoregulation of CBF, thus allowing a drop in CBF during hemorrhagic hypotension. This effect on CBF autoregulation seems to be less pronounced than with isoflurane. Cerebral metabolic oxygen requirements decrease, and seizure activity has not been repoed. Propofol and thiopentone are cerebroprotective as they reduce ICP and CMRO2. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e
Category:
Anaesthesia
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