Which inhalational anaesthetic agent is MOST appropriate for neuroanaesthesia requiring maintenance of cerebral autoregulation and lowest increase in ICP at equipotent doses?

• A Halothane
• B Desflurane
• C Isoflurane
• D Sevoflurane at ≤1 MAC ✓

Explanation

Sevoflurane at concentrations ≤1 MAC maintains cerebral autoregulation and produces minimal cerebral vasodilation with the least increase in CBF and ICP among modern inhalational agents. At >1 MAC, even sevoflurane impairs autoregulation. Halothane is a potent cerebral vasodilator producing marked ICP elevation and has been abandoned. Desflurane causes significant sympathetic stimulation and ICP elevation. Isoflurane at 1 MAC begins to impair autoregulation. Sevoflurane is therefore the preferred inhalational agent for intracranial procedures.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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