All volatile halogenated agents are known to be DIRECT cerebral vasodilators. Which of the following has the LEAST cerebral vasodilation properties?

A. Isoflurane

B. Halothane

C. Sevoflurane

D. Desflurane

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Answer

The answer is C. All volatile agents are direct cerebral vasodilators, with halothane, isoflurane and desflurane being the most potent and sevoflurane the least potent. Pediatric patients, in particular, may have an increased sensitivity to the vasodilation of inhalational anesthetics. Most inhalational anesthetics agents are also known to decrease cerebral metabolic rate (CMRO2). This decrease is probably the least with halothane and greatest with isoflurane and sevoflurane. This increase in cerebral blood flow (CBF) with a decrease in metabolic demand is termed "uncoupling".

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