Hypotension is caused by all except:
Ans: C. KetamineRef: Ajay Yadav; Short Textbook of Anaesthesia 1st edition PG: 76 & Miller Textbook of Anaesthesia. 6th editionExplanation:KetamineCauses Dissociative anesthesiaPhencyclidine derivativeNMD A receptor agonistAnesthetic PropertiesOnset of Action: 30 - 60 secondsEarly regain of consciousness after 15-20 min due to RedistributionElimination half life: 2-3 hoursStrong analgesic propertyMetabolised in Liver and products exreted in urineNot a muscle relaxantPrimary site of action - Thalamo-neo-cortical projectionsCardiovascular systemIncreases arterial BP.Increases heart rate &Increases cardiac outputIV agent of choice in SHOCKRespiratory systemPotent Bronchudilator,Good induction agent for asthmaticsUpper airway reflexes remain largely intactIncreases salivatory & Tracheo bronchial secretionsUsing glvcopv roll ate or atropine becomes necessaryCentral Nervous SystemIncreases Intracranial pressure and can precipitate seizuresEmergence reactions:These are seen at emergenceVivid dreamingIllusionsExtracorporeal experiences like floatingExcitementConfusionEuphoriaFearHallucinations:Auditory and Visual hallucinations (MC side effect of Ketamine)Treated with BenzodiazepineOther SystemsEye:Increase intraocular tensionPupils dilate moderatelyNystagmusGITIncreases intragastric pressureSalivary secretions increasedMuscluarIncreases muscle toneIncreased non-puposeful movementsDoseCan he given IV, IM.oral, Rectal and intrathecal routeIV - 2mg/kgIM- 5-10mg/kgAdvantagesInduction Agent of Choice inAsthmaticsShock (HYPOTENSION)Children (Now Sevoflurance is DOC)Constrictive pericarditisCardiac tamponadeCan be used as SOLE agentCan be used safely at remote places and in inexperienced hands since does not depress heart or respirationPreferred agent when patient is in FULL STOMACH (Preserves laryngo- pharyngeal reflexes)Contraindicated inHead injuryICSOLEye injuryOpthal pathologyIschemic heart diseaseVascular aneurysmPsychiatric diseasesDrug addictsHypertensives
Halothane
Propofol
Ketamine
Thiopentone
Miscellaneous General Anesthesia