Question

Which is the inducing agent of choice in a patient presenting with shock?

• A. Isoflurane
• B. Desflurane
• C. Ketamine
• D. Thiopentone

Hint:

Pick the induction agent that raises BP via sympathetic stimulation.

Answer 1

The Correct Option is C

Step 1: In shock the priority is to maintain blood pressure and cardiac output, so the ideal induction agent should support haemodynamics rather than depress them.

Step 2: Ketamine causes sympathetic stimulation, releasing catecholamines that raise heart rate, blood pressure and cardiac output. This makes it the induction agent of choice in shock and in hypovolaemic or trauma patients. It is also the inducing agent of choice in asthma and COPD because of its bronchodilator action.

Step 3: Thiopentone (a barbiturate) is a potent cardiovascular and respiratory depressant that drops blood pressure, so it is dangerous in a shocked patient. Isoflurane and desflurane are inhalational maintenance agents and also reduce systemic vascular resistance, so neither is the induction agent of choice here.

Step 4: Hence the correct answer is Ketamine.