Anesthetic Agents of Choice & Contraindications

Anesthetic Agents of Choice & Contraindications

• Ketamine: Preferred in bronchial asthma due to its potent bronchodilator effect.

• Ketamine Contraindications: Avoid in hypertension, ischemic heart disease (IHD), increased intracranial pressure (ICT), intraocular pressure (IOP), and psychiatric disorders (e.g., schizophrenia).

• Isoflurane: Ideal for neuro and cardiac anesthesia due to its ability to maintain cerebral perfusion and hemodynamic stability.

• Isoflurane Contraindications: Avoid in hypotension, coronary steal syndrome (in CAD), and patients prone to bronchospasm.

• Isoflurane > Desflurane for Hepatic Anesthesia: Isoflurane is safer than desflurane in liver disease due to lower metabolism-related toxicity.

• Desflurane Contraindications: Avoid in severe liver dysfunction and patients with asthma (due to airway irritation).

• Sevoflurane: Best for pediatric anesthesia due to its non-irritant, smooth induction, and rapid onset.

• Sevoflurane Contraindications: Avoid in renal dysfunction (due to fluoride ion nephrotoxicity) and malignant hyperthermia-prone patients.

• Desflurane for Daycare Surgery: Preferred due to low blood-gas solubility, fast onset, and quick emergence.

• Desflurane Contraindications: Avoid for induction (due to airway irritation), patients with severe cardiac disease (tachycardia risk).

• Propofol: IV Agent of Choice for Daycare Surgery: Due to rapid onset, short duration, and antiemetic effects.

• Propofol Contraindications: Avoid in hemodynamically unstable patients, egg/soy allergy, and risk of propofol infusion syndrome (PRIS) in prolonged use.

• Etomidate: Hemodynamically Stable Induction: Preferred in cardiovascular instability due to minimal effects on BP.

• Etomidate Contraindications: Avoid in adrenal insufficiency (as it suppresses cortisol synthesis).

• Thiopental: Neuroprotective Anesthetic: Used in neurosurgery for its cerebral protection in head trauma and stroke.

• Thiopental Contraindications: Avoid in hypotension, porphyria, and obstructive airway disease.

• Lidocaine: Local Anesthetic of Choice: Used in minor surgeries, epidurals, and nerve blocks.

• Lidocaine Contraindications: Avoid in methemoglobinemia and severe hepatic disease.

• Bupivacaine: Long-acting Local Anesthetic: Preferred for spinal and epidural anesthesia.

• Bupivacaine Contraindications: Avoid in cardiac disease (risk of cardiotoxicity at high doses).

• Spinal/Epidural Anesthesia Contraindications: Avoid in coagulopathy, severe hypovolemia, and sepsis.