Neuroanesthesia: A Review of the Effects of Anesthetic Agents on Cerebral Blood Flow and Intracranial Pressure in the Dog

Successful anesthetic management of dogs with reduced intracranial compliance requires a knowledge of the effects of various anesthetic agents on cerebral blood flow and intracranial pressure. The major physiologic factors that influence cerebral blood flow and intracranial pressure (ICP) include the cerebrovascular autoregulatory mechanism, intracranial compliance, blood pressure, and the partial pressure of carbon dioxide. Intravenous and inhalation anesthetic agents alter cerebral blood flow and intracranial pressure in the dog. These alterations can have profound effects in dogs with reduced intracranial compliance, necessitating proper anesthetic management. Suggested guidelines for neuroleptanesthetic and inhalation anesthesia regimens in dogs with reduced intracranial compliance include thorough presurgical evaluation, minimal patient stress during induction, use of an anesthetic protocol that minimizes ICP effects, and hyperventilation to maintain a Pco₂ within a range of 25 to 35 mm Hg.