Which of the following combinations can be used for day care surgery?
Ans. a. Ramifentanyl, midazolam, propofol (Ref: Millers Anesthesia 8/e p726; Lee 13/e p158-160; Morgan 3/e p173, 884) Drug combination, which can be used for day care surgery are ramifentanyl, midazolam and propofol."Any induction agents used in day-case anesthesia should ensure a smooth induction, good immediate recovery and a rapid return to street fitness. Propofol is now used widely as the primary induction agent, which has advantage of rapid recovery and low incidence of post-operative nausea and vomiting. "Preferable agents in Day Care AnaesthesiaMivacuriumQ (muscle relaxant of choice, shortest duration of action)SuccinylcholineQ (for Ultra short period of profound muscle relaxation; Disadvantage: Post-operative myalgia)IsofluraneQ (volatile inhalational agent)AlfentanylQPropofolQ (inducing agent of choice)MidazolamQ (for initial anaxiolysis and sedation)Mnemonic: Manmohan Singh Is A Prime MinisterAnesthetic Agent of Choice* Day carePropofolQ* Ischemic heart diseaseEtomidateQ* Congenital heart disease (left to right shunt): ASD, VSD, PDASevofluraneQ* Congenital heart disease (right to left shunt)* Congestive heart failure* Shock* Asthma and COPDKetamineQ* For producing deliberate hypotension* Cardiac surgery* NeurosurgeryIsofluraneQ* Epilepsy* ThyrotoxicosisThiopentoneQ* For electroconvulsive therapyMethohexitoneQ
Ramifentanil. midazolam, propofol
Fentanyl, midazolam, thiopentone sodium
Morphine, midazolam, propofol
Morphine, diazepam, ketamine
Miscellaneous General Anesthesia