Which of the following induction agent produce cardiac stabilityaEUR'
Etomidate Effects of Etomidate on cardiovascular system Etomidate has minimal effects on the cardiovascular system. It causes mild reduction in peripheral vascular resistance which may cause a slight decline in aerial blood pressure. Myocardial contractility and cardiac output are usually unchanged. Etomidate does not release histamine. Cardiovascular effect of Propofol : The major cardiovascular effect of propofol is a decrease in aerial blood pressure due to a drop in systemic vascular resistance (inhibition of sympathetic vasoconstrictor activity, cardiac contractility and preload). Propofol markedly impairs the normal aerial baroreflex response to hypotension. Sometimes there may be a marked drop in preload. Cardiovascular effect of barbiturates (Thiopental) The cardiovascular effect of barbiturates vary markedly depending on the volume status, basline autonomic tone and preexisting cardiovascular disease. Normally, intravenously administered barbiturates cause a fall in blood pressure. Cardiac output is maintained due to increase in hea rate and increased myocardial contractility from compensatory baroreceptor reflexes. However, in the absence of adequate baroreceptor response (e.g., hypovolemia. congestive hea ,failure, 13 adrenergic blockade) cardiac output and aerial blood pressure may fall dramatically due to uncompensated pooling and unmasked direct myocardial depression. Effect of ketamine on cardiovascular system Ketamine causes central stimulation of sympathetic system which causes increased aerial blood pressure, hea rate and cardiac output. There is also increase in pulmonary aery pressure and myocardial work. Because of these effects, ketamine should be avoided in patients with coronary aery disease, uncontrolled hypeension, congestive hea failure and aerial aneurysms.
Ketamine
Etomidate
Propofol
Midazolam