Intravenous Induction Agents & Commonly Used Drugs

IV induction agents rapidly induce unconsciousness. Propofol is first-line for stable patients (antiemetic, rapid recovery). Etomidate is hemodynamically neutral for RSI in shock but causes adrenal suppression. Ketamine supports BP in hypovolemia/asthma but may increase ICP. Thiopental is now largely replaced due to cardiovascular risks.

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Clinical Scenarios & Adjuncts in IV Induction

Etomidate/ketamine for hemodynamic instability (e.g., septic shock). Propofol for raised ICP. Ketamine for bronchospasm. Adjuncts like opioids blunt intubation response; lidocaine reduces injection pain; muscle relaxants optimize intubation. Always tailor to comorbidities and hemodynamics.

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Experimental Anesthetic Agents & TIVA

Novel Anesthetic Agents

Fospropofol (less pain), ABP-700 (no adrenal suppression), and remimazolam (rapid recovery) aim to overcome limitations of currently used anesthetic agents. TIVA (propofol ± remifentanil) avoids inhalational gases, ideal for MH risk or PONV-prone patients. Requires infusion pumps and awareness monitoring (e.g., BIS).

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Intravenous Induction: The Gateway to General Anesthesia

Intravenous Drug Induction

IV induction rapidly induces unconsciousness (15–60 sec) via intravenous drugs, enabling airway management. Preferred for speed, predictability, and patient comfort, it avoids inhalational agents’ irritancy. Key advantages include precise titration, hemodynamic control, and suitability for rapid sequence intubation (RSI). It remains the standard for adult anesthesia induction.

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