Special anaesthesia: raised intracranial pressure: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Special anaesthesia: raised intracranial pressure

Sample item

Which measure helps lower intracranial pressure during neuroanaesthesia?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Moderate hyperventilation to a PaCO2 of 30 to 35 mmHg and head-up tilt

Reducing PaCO2 constricts cerebral vessels and cuts blood volume, while head elevation of about 15 to 30 degrees improves venous drainage. Mannitol 0.25 to 1 g/kg and propofol-based anaesthesia also help.

Option by option

  • A. High dose volatile agent

    High-dose volatile agents dilate cerebral vessels.

  • B. Use of suxamethonium and ketamine only

    These drugs do not reduce ICP.

  • C. Hypoventilation to PaCO2 of 50 mmHg

    Hypercapnia raises ICP.

  • D. Moderate hyperventilation to a PaCO2 of 30 to 35 mmHg and head-up tilt (correct)

    Correct. Mild hyperventilation and head-up tilt lower ICP.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Moderate hyperventilation to a PaCO2 of 30 to 35 mmHg and head-up tilt. Reducing PaCO2 constricts cerebral vessels and cuts blood volume, while head elevation of about 15 to 30 degrees improves venous drainage.

Why is "High dose volatile agent" not the answer?

High-dose volatile agents dilate cerebral vessels.

Why is "Use of suxamethonium and ketamine only" not the answer?

These drugs do not reduce ICP.

Why is "Hypoventilation to PaCO2 of 50 mmHg" not the answer?

Hypercapnia raises ICP.

What concept does this question test?

It tests Special anaesthesia: raised intracranial pressure in Anaesthesia. Mannitol 0.25 to 1 g/kg and propofol-based anaesthesia also help.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Special anaesthesia: raised intracranial pressure?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.