Propofol infusion syndrome is a safety concern associated with what therapy in ICP management?

• A. Propofol infusion syndrome
• B. Serotonin syndrome
• C. Malignant hyperthermia
• D. Neuroleptic malignant syndrome

Answer: (B)

Propofol infusion syndrome is a serious safety concern tied to using propofol for deep, continuous sedation during intracranial pressure management. It tends to occur with prolonged high-dose infusions and can manifest as metabolic acidosis, rhabdomyolysis with elevated CK, hyperkalemia, cardiac dysfunction or arrhythmias, renal failure, and hemodynamic collapse. The underlying issue is thought to be mitochondrial dysfunction and impaired fatty acid oxidation from sustained propofol exposure, so the key prevention is limiting dose and duration, with close monitoring of metabolic and organ function and considering alternative sedatives if ICP control requires deep sedation. If PRIS is suspected, stop propofol immediately and provide comprehensive supportive care, including hemodynamic support and treatment of electrolyte and acid-base disturbances. The other syndromes listed—serotonin syndrome, malignant hyperthermia, and neuroleptic malignant syndrome—are distinct conditions with different triggers and clinical pictures.