Anesthetics that decrease ICP include which of the following?

Anesthetics that decrease ICP include which of the following?

• A. Isoflurane
• B. Nitrous oxide
• C. Propofol
• D. Sevoflurane

Answer: (C)

Propofol lowers intracranial pressure by reducing the brain’s metabolic demand for oxygen (CMRO2). When CMRO2 drops, cerebral blood flow (CBF) follows because flow is tightly linked to metabolic needs. The result is less cerebral blood volume and lower ICP. Propofol also tends to cause cerebral vasoconstriction, further reducing blood volume in the cranium. In contrast, the inhaled agents listed generally cause cerebral vasodilation, increasing CBF and often raising ICP, especially at higher concentrations. Nitrous oxide can expand gas spaces and raise ICP as well. Sevoflurane and isoflurane tend to increase cerebral blood flow through vasodilation, making them less favorable when ICP reduction is needed. Thus, propofol is the agent that reliably decreases ICP.

Propofol lowers intracranial pressure by reducing the brain’s metabolic demand for oxygen (CMRO2). When CMRO2 drops, cerebral blood flow (CBF) follows because flow is tightly linked to metabolic needs. The result is less cerebral blood volume and lower ICP. Propofol also tends to cause cerebral vasoconstriction, further reducing blood volume in the cranium.

In contrast, the inhaled agents listed generally cause cerebral vasodilation, increasing CBF and often raising ICP, especially at higher concentrations. Nitrous oxide can expand gas spaces and raise ICP as well. Sevoflurane and isoflurane tend to increase cerebral blood flow through vasodilation, making them less favorable when ICP reduction is needed.

Thus, propofol is the agent that reliably decreases ICP.