A patient with ruptured spleen is taken for laparotomy. His blood pressure is 80/50 and hea rate is 125/min. Induction agent Of choice for this patient is:
Thiopentone sodium causes BP fall immediately after injection due to vasodilatation. Fentanyl decreases hea rate as it stimulates vagus and a slight fall in BP occurs. Ketamine increases hea rate , cardiac output and BP due to sympathetic stimulation. Halothane causes direct depression myocardial contractility by reducing intracellular calcium concentration. Cardiac output is reduced with deepening anesthesia. 20-30Hg fall in BP is common. Here the patient is already having hypo tension. Hence ketamine is used as all other drugs fuher reduce BP. From KD Tripati 7th edition Page no 379,381,384
Sodium Thiopentone
Fentanyl
Ketamine
Halothane
Anesthesia