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General Surgery · Perioperative care: induction agent in hypovolaemia
Sample itemA bronchial asthmatic patient with hypovolaemia from intestinal obstruction needs a rapid sequence induction. Which induction agent is most suitable?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Ketamine
Ketamine stimulates the sympathetic system, maintaining blood pressure and heart rate, and it is a bronchodilator. This suits shocked and asthmatic patients. Propofol and thiopentone cause vasodilatation and myocardial depression, so hypotension may be severe in hypovolaemia.
Option by option
A. Propofol
Propofol causes marked vasodilatation and hypotension in hypovolaemic patients.
B. Midazolam
Midazolam is slow in onset and a poor choice for rapid sequence induction.
C. Thiopentone
Thiopentone causes hypotension and can provoke bronchospasm.
D. Ketamine (correct)
Correct. Ketamine preserves haemodynamics and relaxes bronchial smooth muscle.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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