67 Questions
What is the primary mechanism by which volatile anesthetics affect cerebral blood flow?
Direct effect on vascular smooth muscle
At 0.5 MAC of volatile anesthetics, what is the effect on cerebral blood flow?
Decreased due to cerebral metabolic rate suppression
What happens to autoregulation with larger doses of volatile anesthetics?
It is abolished
How does the CBF/CMR ratio change with increasing doses of volatile agents?
Increases
Which volatile anesthetic leads to the greatest vasodilating potency?
Halothane
What is the clinical consequence of administering volatile anesthetics in terms of cerebral perfusion and intracranial pressure?
Increased cerebral blood flow (CBF) leading to higher ICP
At 1 MAC of volatile anesthetics, what is the effect on cerebral blood flow?
Unchanged
At 1.5 MAC of volatile anesthetics, what is the effect on cerebral blood flow?
Increased due to vasodilatory activity
What effect does 1 MAC halothane have on cerebral blood flow when maintaining mean arterial pressure (MAP) at 80 mm Hg?
Increases by 191%
How does 1.2 MAC of enflurane affect cerebral blood flow (CBF)?
Increases CBF by 45%
Which of the following statements is true regarding sevoflurane at 1 MAC?
Decreases CBF by 50% and CMR by 50%
What is the primary mechanism through which xenon exerts its anesthetic effect on cerebral blood flow?
Noncompetitive antagonism of NMDAR
What effect does sevoflurane have on cerebral blood volume (CBV) at a reduced cerebral blood flow (CBF)?
Maintains CBV
Which volatile anesthetic shows both an increase in cerebral blood flow (CBF) and a decrease in cerebral metabolic rate (CMR) at 1.1 MAC?
Isoflurane
At what MAC does the occurrence of EEG suppression typically happen with isoflurane, desflurane, and sevoflurane?
1.5 - 2 MAC
Which volatile anesthetic requires concentrations greater than 4 MAC to achieve EEG suppression?
Halothane
What occurs with additional halothane administration above 4 MAC, according to the text?
Further reduction in CMRo2
Which volatile anesthetic results in slightly less suppression of CMR compared to isoflurane?
Desflurane
What effect does additional isoflurane above 6% end-tidal concentration have on CMR?
No change in CMR
What effect does propofol have on regional cerebral blood flow (CBF) and regional cerebral blood volume (CBV)?
Decreases both CBF and CBV
How does cerebral blood volume (CBV) respond to changes in PaCO2?
Decreases with hypocapnia and increases with hypercapnia
In comparison to the change in cerebral blood flow (CBF), how does the change in cerebral blood volume (CBV) respond to alterations in Paco2?
CBV changes are less than CBF changes
Which anesthesia results in greater cerebral blood volume (CBV) compared to propofol or pentobarbital?
Isoflurane
What effect does 1 minimum alveolar concentration (MAC) of sevoflurane have on regional cerebral blood flow (CBF) and regional cerebral blood volume (CBV)?
Decreases regional CBF but does not affect CBV
Which of the following best describes the effect of volatile anesthetics on carbon dioxide responsiveness?
CO2 responsiveness is well maintained
Which volatile anesthetic is mentioned in the text as potentially causing less impairment of autoregulatory response to increasing blood pressure?
Sevoflurane
Which statement accurately describes the effect of volatile anesthetics on cerebral blood flow (CBF) when maintaining mean arterial pressure (MAP)?
CBF is preserved up to lower MAP values
How does autoregulation of cerebral blood flow respond to increasing arterial blood pressure during anesthesia with highly cerebral vasodilatory anesthetics?
Autoregulation is impaired
In a patient with a large mass and compressed basal cisterns, what anesthetic technique is advised until the cranium and dura are open?
Predominantly IV technique
What effect does isoflurane have on cerebral blood flow (CBF) when introduced under thiopental anesthesia?
Significantly increases CBF
Which drug administration or disease process justifies caution in the use of volatile anesthetics due to decreased cerebral metabolic rate (CMR)?
Traumatic brain injury
What happens when volatile agents are introduced after prior propofol anesthesia?
Significant increase in CBF
Under what circumstances does isoflurane not cause a significant increase in CBF?
When CMR is slightly reduced by morphine
What effect does the introduction of volatile anesthetics have on cerebral blood flow (CBF) when cerebral metabolic rate (CMR) has been maximally suppressed?
Significant increase in CBF
How do modest reductions in cerebral blood flow (CBF) typically correlate with changes in cerebral blood volume (CBV) according to the text?
Modest reductions in CBF may not necessarily be accompanied by reductions in CBV.
In patients with normal intracranial compliance, what effect do volatile anesthetics have on cerebral hemodynamics?
Volatile anesthetics have modest effects on cerebral hemodynamics.
How does hypocapnia influence the increase in intracranial pressure (ICP) induced by isoflurane administration according to the text?
Hypocapnia mitigates the increase in ICP.
What is the clinical implication of administering volatile anesthetics to patients with abnormal intracranial compliance?
Volatile anesthetics increase CBV and ICP.
How does hyperventilation typically affect isoflurane-induced increases in intracranial pressure (ICP) in patients with intracranial tumors?
Hyperventilation has no effect on the isoflurane-induced increases in ICP.
What effect do volatile anesthetics have on intracranial pressure (ICP) in experimental investigations of cerebral injury according to the text?
Volatile anesthetics significantly increase ICP.
What is the impact of administering nitrous oxide (N2O) alone on cerebral blood flow (CBF) and intracranial pressure (ICP)?
Increase in CBF, CMR and ICP
How does the presence of intravenous (IV) anesthetics affect the cerebral vasodilating effect of Nitrous oxide (N2O)?
Attenuates or inhibits the effect
What is the impact of administering 50% N2O during barbiturate anesthesia in patients with intracranial tumors and poor compliance?
Negligible effect on CBF and ICP
Which effect does administering Nitrous oxide (N2O) with IV agents such as barbiturates, benzodiazepines (BNZ), narcotics, or propofol have on its cerebral vasodilating effect?
Attenuates or completely inhibits the effect
What should be considered when administering Nitrous oxide (N2O) in circumstances where intracranial pressure (ICP) is persistently elevated or the surgical field is persistently tight?
Avoid using N2O
How does the simultaneous administration of IV anesthetics affect the cerebral vasodilation induced by Nitrous oxide (N2O)?
Reduces the vasodilating effect of N2O
The most dramatic increases in ICP or CBF occurred when N2O was administered
when was administered alone
How does the concentration of inhaled drug correlate with the vasodilating effect of N2O?
The effect is exaggerated at higher concentrations.
What impact did administering 50% N2O to healthy volunteers have on cerebral blood volume (CBV)?
No significant alteration in CBV.
When N2O was added to a background of 1 MAC sevoflurane anesthesia, what effect did it have on cerebral blood volume (CBV)?
Had no effect on CBV.
What do the data presented in the text suggest about the relationship between N2O and cerebral blood volume (CBV)?
N2O moderately affects CBV.
Which muscle relaxant is mentioned as having the most rapid onset time in the text?
Rocuronium
What does the text suggest can be used to rapidly reverse a profound neuromuscular blockade (NMB)?
Sugammadex
In which instances should doses of metocurine, atracurium, and mivacurium be limited ?
limited to ranges not associated with hypotension
What was observed regarding intracranial pressure (ICP) after the administration of succinylcholine to nonparalyzed, ventilated neurosurgical patients in the ICU?
No change in ICP
How can succinylcholine-induced increases in ICP be prevented based on the text?
With deep anesthesia
What is the primary mechanism of action of Nondepolarizing muscle relaxants and effect on ICP?
Release of histamine leading to increased cerebral blood flow (CBF)
Which muscle relaxant has the highest potency as a histamine releaser according to the text?
D-Tubocurarine
Which muscle relaxant is least likely to have a significant effect on cerebral physiology?
Vecuronium
What is the likely clinical significance of histamine release by muscle relaxants?
Increased risk of cerebral vasodilation with large doses
What is the effect of cisatracurium compared to other muscle relaxants in terms of histamine release?
Least potent among all muscle relaxants mentioned
WHICH anesthetic drug increase secretion and no effect on absorption ?
Desflurane
WHICH anesthetic drug increase absorption and no effect on secretion ?
Isoflurane
WHICH anesthetic drug increase absorption and decrease secretion ?
Etomidate
WHICH anesthetic drug decrease absorption and increase secretion ?
Enflurane
WHICH anesthetic drug decrease absorption and secretion ?
Halothane
How do tight junctions in the brain affect the pore size between endothelial cells?
Decrease the pore size to 8 Å
Explore the impact of volatile anesthetics on cerebral blood flow by understanding the dose-response relationship. Learn how these anesthetics affect cerebral metabolic rate, cerebral blood flow, and cerebral vasodilation.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
