Anesthetic of choice for day care procedures is?
Ans. is 'c' i.e., Propofol Ambulatory (outpatient/day care) anaesthesia -* Ambulatory or day care or outpatient anaesthesia means, patient comes on same day, gets operated and is discharged on same day. So, the drugs used in outpatient anaesthesia are those which have short duration of action. Anaesthetic techniques and agents ideal for day care surgery are: -Premedication* Usually premedication is not used. However in anxious patients, midazolam is the drug of choice, which should be given 1-2 hours before the surgery with sip of water by oral route or 30 min. before surgery by im route. If patient is prone to nausea and vomiting, dolasetron is the drug of choice. Ondansetron is an alternative.Airway* Laryngeal mask airway is preferred over intubation.Intravenous anaesthetics* Intravenous route is the preferred method for induction. Propofol is the intravenous anaesthetic of choice for induction because of its smooth induction and rapid recovery. Antiemetic action of propofol is also beneficial - use of propofol for induction or maintenance of anaesthesia is associated with a reduced incidence of post- operative nausea and vomiting.Inhalational agents* Inhalational anaesthetics are preferred for the maintenance. Desflurane (1st choice) and sevoflurane (2nd choice are the agents of choice. These agents are used along with N2O as N2O decreases the requirement of other anaesthetics hence fastening the recovery. Halothane and isoflurane have largely been replaced by the less soluble desflurane and sevoflurane.Muscle relaxants* Mivacurium is the muscle relaxant of choice because of its short duration of action. Succinylcholine should be avoided as it causes post-operative myalgia. However, if intubation is required, succinylcholine remains the agent of choice.Opioid analgesics* Opioids compounds are frequently administered during anaesthesia to suppress autonomic responses to tracheal intubation and painful (noxious) surgical stimuli. These drugs are also useful supplements to inhaled anaesthetics during maintenance period. Alfentanil is the agent of choice because of rapid onset and shorter duration of action. Remifentanil is emerging as an alternative because of much shorter duration of action. Fentanyl or sufentanil can also be used.
Morphine
Ketamine
Propofol
Diazepam
General Anesthesia