Which intravenous anaesthetic agent is traditionally avoided for induction in a patient with intracranial hypertension because it increases cerebral blood flow and intracranial pressure?

• A Propofol
• B Etomidate
• C Midazolam
• D Ketamine ✓

Explanation

Ketamine increases cerebral blood flow, cerebral metabolic rate and intracranial pressure through cortical activation, and is therefore classically avoided in neuroanaesthesia, particularly with uncontrolled ventilation. Propofol, etomidate and midazolam all reduce cerebral metabolic rate and cerebral blood flow in a coupled fashion and lower ICP. Newer studies suggest ketamine may be safe under controlled ventilation with propofol coadministration, but examination convention retains the classical teaching.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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