Which of the following combinations can be used for day care surgery?
Ramifentanil. midazolam, propofol
Fentanyl, midazolam, thiopentone sodium
Morphine, midazolam, propofol
Morphine, diazepam, ketamine
Ans. a. Ramifentanyl, midazolam, propofol (Ref: Millers Anesthesia 8/e p726; Lee 13/e p158-160; Morgan 3/e p173, 884) Drug combination, which can be used for day care surgery are ramifentanyl, midazolam and propofol."Any induction agents used in day-case anesthesia should ensure a smooth induction, good immediate recovery and a rapid return to street fitness. Propofol is now used widely as the primary induction agent, which has advantage of rapid recovery and low incidence of post-operative nausea and vomiting. "Preferable agents in Day Care AnaesthesiaMivacuriumQ (muscle relaxant of choice, shortest duration of action)SuccinylcholineQ (for Ultra short period of profound muscle relaxation; Disadvantage: Post-operative myalgia)IsofluraneQ (volatile inhalational agent)AlfentanylQPropofolQ (inducing agent of choice)MidazolamQ (for initial anaxiolysis and sedation)Mnemonic: Manmohan Singh Is A Prime MinisterAnesthetic Agent of Choice* Day carePropofolQ* Ischemic heart diseaseEtomidateQ* Congenital heart disease (left to right shunt): ASD, VSD, PDASevofluraneQ* Congenital heart disease (right to left shunt)* Congestive heart failure* Shock* Asthma and COPDKetamineQ* For producing deliberate hypotension* Cardiac surgery* NeurosurgeryIsofluraneQ* Epilepsy* ThyrotoxicosisThiopentoneQ* For electroconvulsive therapyMethohexitoneQ
Miscellaneous General Anesthesia