IV Anesthetics (rapid onset (<1 min), short duration (5-8 minutes)

Question 1

Thiopental

Answer 1

pro- cheap, stops seizures, excellent brain protection

cons- myocardial depression, vasodilation, histamine release, can precipitate porphyria in susceptible patients

Question 2

Propofol

Answer 2

pro- anti-emetic, quick recovery if used as a solo anesthetic agent
con- pain on injection, expensive, supports bacterial growth, myocardial depression (the most of the four), vasodilation

Question 3

Etomidate

Answer 3

pro- least myocardial effect of IV anesthetics

con- pain on injection, adrenal suppression (significant if used alone for induction), myoclonus, n/v

Question 4

Ketamine

Answer 4

pro- works IV, PO, PR, IM, good choice in uncooperative patient without IV, SNS stimulation; good for hypovolemic trauma patients, often preserves airway reflexes
con- dissociative anesthesia with postop dysphoria and hallucinations, increases ICP/IOP and CMRO2, SNS stim undesirable in patient with compromised cardiac function, increases airway secretions