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Wednesday, January 09, 2008

Propofol suitable for day care surgery

026. Which of the following intravenous induction agents is the most suitable for day care surgery?

1. Morphine

2. Ketamine

3. Propofol

4. Diazepam

Answer

3. Propofol

Reference

Clinical Anaesthesia 3rd Edition – Morgan Page 173

Also seen in

KDTripathi,5th Edition Page 343

Lee, 12th Edition, Pages 176, 417

SARP - SARP 6th Edition Page 108

PARAS - PARAS 4th Edition Page 46

Sure Sucess in PG Entrance 1st Edition Page 93

Quality

Spotter

Status

Repeat - All India 2003 - See Q.No 3 in RxPG AIPG 2003 Book and Q.No 1 in AIPG 2004 books

QTDF

All books give this

Discussion

Propofol is Di-Isopropylphenol

Ä It is prepared as an emulsion in 10% Soyabean oil and 1.2% egg phosphatide and 2.25%Glycerol

Ä Induction dose is 2-3 mg/kg

Ä Highly lipophilic

Ä 30%-40% of patients complain of pain/burning during injection.

Ä Induction is rapid and recovery of consciousness after 4-7 minutes

Ä Post anaesthetic Performance of Mental, Manual and Mechanical task is back to normal within 1-2 hours

Ä Suited for Day care Surgery

Ä Safe for patients with Acute Intermittent Porphyria

Ä It does not trigger Malignant hyperthermia

Ä Hypotension is a common side effect

Ä Apnoea is common after induction and may last for 40-50 seconds

Ä Antioxidant

Ä Antiemetic

Ä Antipruritic

Explanation

Self Explanatory.

Comments

Ketamine is the anaesthesia of choice for patients in shock and produces delirium and is not the drug for Day Care Anaesthesia. Morphine is used for pain relief and Diazepam for sedation

Tips

This is an Often Repeated Question. Similarly there is a long list of what to use and what not to use in each specific conditions and the fact is that those are asked often and you have no other way than to prepare them. Know the key details about all the anaesthetic agents.

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