Intravenous anaesthetic Induction agent used in Day care surgery is:: (A) Propofol, (B) Ketamine, (C) Etomidate, (D) Thiopentone
Answer is A. Ref: Ajay Yadav, Short textbook of Pediatrics 1st edition Pg 73 (4 Miller text book of Anaesthesia. 6th editionExplanation:PROPOFOLComercial prepartions is Oil based and contains Soyabean oil. Egg Lecithin & GlycerolCauses pain during injection, avoided by prior injection by lignocaineCan support the growth of bacteria, to be used within 6 hrs of opening the vialDrug of choice for day care surgeryAnesthetic propertiesInduction is achieved in 15 seconds (Arm brain circulation time)Consciousness is regained in 5 - 10 minutes (due to redistribution)Elimination half life - 2-4 hoursNo analgesic propertyNot a muscle relaxantMetabolismMetabolised by liver and excreted by kidneysClearance rate is 20 times more rapid than ThiopentoneSystemic EffectsMajor CVS effect is hypotension and vagal bradycardiaBetter blunting of airway reflexes compared to thiopentoneRespiratory depression is more severe than ThiopentoneHas Cerebral protection effect (Similar to thiopentone)Can cause muscle twitchings or myoclonusHas antiemetic propertyAntipruritic propertyDecreases intraocular pressureUsesAgent of choice for Day care anesthesiaAgent of choice for total intravenous anesthesia (TIVA) in combination with FentanylUsed to produce sedation in ICUAgent of choice in patients susceptible to Malignant hyperthermia