<prompt> In which of the following condition ketamine can be used:HypovolemiaMyocardial infarctionHypertensionHead injury  <response>: Ans: a Hypovolaemia Ref: Ajay Yadav, 2nd ed, p. 78,139,141Ketamine stimulates sympathetic system causing:TachycardiaHypertensionIV anaesthetic of choice in shock ie good for hypovolaemic patientsIV anaesthetic of choice in asthmaticsCauses dissociative anaesthesia, i.e.. a state of profound analgesia, light sleep, increased muscle tone and emergence deliriumMarked analgesia is a prominent feature and more analgesic than propofol and thiopentanone causes increased muscle tone and myalgia.It is anaesthetic of choice in skin grafting.Dissociative anaesthesia is due to excitation of limbic system and inhibition of thalamus and neocortex.pH of 10 solution is 4IV doseIM doseInfusion rateOral dose- 1 -2 mgkg of body weight- 6-10 mgkg- 40 microgram kgmt- 6 mgkgSide effects:Increase all pressures! intracranial, intraocular, blood pressurePost operative myalgia and myoglobinuriaHallucination and diazepam is used for treatmentIncreased salivation use atropineDrug of choiceHepatic failureRenal failureAnaesthetic agentIsoflurane sevofluraneIsoflurane sevofluranedesflurane halothaneMuscle relaxantAtracurium cisatracuriumAtnicuiium cisatracurium fentanylOpiodFentanylFentanylContraindicationNoneMethoxyflurane gallaminc enfluraneAnaesthetic of choice in:Cardiac patientsDay care surgeryIntravenous- etomidateAnaesthesia- propofol alfentanyl isofluraneInhalation- isofluraneOpiod- alfentanyl fentanylMR- vecuroniumShock patient- IV ketamineAsthmatic patientNeonates and childrenIntravenous- ketamineInhalation- sevofluraneInhalation- halothaneIntravenous- thiopentoneMR- pancuronium propofol Neurosurgical operationsAneurysm surgery-Isoflurane thiopentone propofolEtomidateElectroconvulsive therapy-Total intravenous anaesthesia-MethohexitoneProporfol -falfentanyl fentanylPatient susceptible to malignant hyperthermiaControlled hypotensionInduction- propofolIsoflurane Maintenance- nitrous oxide Local anaesthesia-- procainePhaeochromocytomaEnfluraneHaemorrhagic shock- cyclopropaneEpilepticsInduction - thiopentoneMaintainence - isofluraneSkin grafting- ketamine Muscle relaxant causing histamine release MASTMivacuriumAtracutiumSuccinylcholineD-Tubocurarine 