A case of road traffic accident (A) came with head injury, BP is 90/60, pulse is 150/min. Which anesthetic agent should be used for induction.
A i.e. Thiopentone In head injury, induction is preferably done by thiopental or propofol (both neuroprotective)Q and a rapid onset NMBD (usually rocuronium or mivacurium) following adequate preoxygenation hyperventilation by mask. A barbiturate (thiopentone) - opioid - N20-NMBA technique is commonly used or intraoperative maintenance anesthesia. Ketamine, halothane, succinylcholine can increase ICP and are better avoidedQ, however, Sch can be used in difficult intubation. Glucose containing or hypotonic crystalloid solutions, sedation without airway control and vasodilators (CCB, hydralazine, nitro-glycerine, nitroprusside) and PEEP are also avoided (or used very cautiously) in head injury.
Thiopentone
Ketamine
Halothane
Succinylcholine