Ketamine contraindicated in all except-
Ans. is 'c' i.e., Asthma o Ketamine increases cerebral blood flow, metabolism, oxygen consumption and intracranial tension, unlike thiopentone, propofol&etomidate, which have cerebroprotectiveeffect, therefore ketamine is contraindicated in head injury, intracranial space occupying lesions and for neuroanaesthesia.o Cerebrovascular responsiveness to CO2 is preserved, and reducing the arterial CO2 tension by hyperventilation attenuates the ketamine induced rise in ICT.o Ketamine has direct myocardial depressant (negative ionotropic) & vasodilator effect. However, ketamine also has indirect sympathomimetic effect. Indirect sympathomimetic effect predominates over direct myocardial depressant & vasodilator effect; usual response is increased BP, cardiac output and heart rate-Cardiac 02 demand is increased.o Ketamine is contraindicated in aortic aneurysm, hypertensive and ischemic heart disease. Ketamine also sensitizes the heart to adrenaline - arrhythmias may occur.o As ketamine cause sympathetic stimulation, it is the intravenous anaesthetic of choice in patients with shock and hypovolemia.o Ketamine increases intra-ocular tension - Contraindicated in glaucoma & open eye surgery,o It is a potent bronchodilator and relieves bronchospasm - Intravenous anesthetic agent of choice in asthmatic (inhalational anaesthetic agent of choice in asthmatics is halothane)o It increases uterine tone and intensity of uterine contraction - agent of choice in patients with obstetric haemorrhage and flaccid uterus.o Injection of ketamine is not painful (all other i.v. inducing agents cause pain on injection).
Head injury
Hypertension
Asthma
Glaucoma
Miscellaneous General Anesthesia