INTRA-VENOUS INDUCTION AGENTS Dr.M.Kannan MD DA Professor And HOD Department of Anaesthesiology Tirunelveli Medical College

General Anaesthesia Premedication Set up Intravenous line Set up Essential Monitors Induction Maintenance Recovery Post operative Care

Thiopental Sodium Yellowish Powder pH 10.8 Given IV Tissue necrosis Intra arterial-

Phamacological Effect -Thiopental Sedation in 30 seconds Recovers in 5-10min CVS -Myocardial depressant -Peripheral vasodilator RS-depression Placental transfer-Yes

Indication Induction of Anaesthesia Status Epilepsy To reduce cerebral oedema Truth extractor

Contraindication Relative Cardiac Failure Pericardial effusion Hypotension-shock Renal failure Absolute Porphyria-lower motor neuron paralysis Airway obstruction

Propofol-Pharmacology CNS sec deep Sedation -Recovery 3-4min least hang over CVS Arterial pressure -Negative inotropic effect RS-Respiratory depressant

Propofol White Aqueous emulsion Soyabean oil & Purified egg phosphalipd Mild irritation to endothelium-pain

Propofol-Anaesthetic Indication Induction of Anaesthesia Sedation during regional Anaesthesia Total Intra venous Anaesthesia Sedation in ICU Preferred in Day care surgery

Ketamine Hydrochloride CNS –Sedation & 1-2 min lost for 10-15min Recovery-hallucination & nightmare Cerebral metabolism Cerebral blood flow No role in SOL

Ketamine Hydrochloride CVS -Hypertension -Tachycardia Oxygen Consumption

Ketamine-Respiratory system Mild depression Broncho dilator Asthmatic patient

Ketamine Indication Dose 2 mg/kg IV-10 mg/kg IM High risk patient-Shock Paediatric- Minor procedure Sedation-Dressing,Examination Developing countries

Ideal Intravenous Agent Rapid onset of action Rapid recovery Good analgesia No hangover effect No cardiac &Respiratory depression No local or allergic reaction No tachyphylaxis