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: A patient in shock already has compromised perfusion and a fragile blood pressure, so the chosen anaesthetic for induction must not worsen circulatory collapse.

Step 2: Among the options, only ketamine is a positive inotrope-like agent in practice. By blocking re-uptake of noradrenaline it triggers a sympathomimetic surge, supporting heart rate and arterial pressure during induction. This same property makes ketamine the preferred inducing agent in bronchospastic disease such as asthma and COPD.

Step 3: The remaining choices fail this requirement. Thiopentone causes marked vasodilation and myocardial depression, precipitating hypotension. Isoflurane and desflurane are volatile agents meant for maintenance and they lower vascular resistance, so they cannot be the induction choice in a hypotensive shocked patient.

Step 4: Therefore the agent that preserves haemodynamics during induction in shock is ketamine.

\[\boxed{\text{Ketamine}}\]