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What is A patient was operated for right upper lobe resection. He was shifted to post awakening recovery after completion of surgery with vitals- BP 100/70 mm of Hg, HR - 94bpm, SPO2 100. After 2 hrs when he was assessed ,his vitals was BP 70/50 mm of Hg. HR-126 bpm ,SPO2 92 and surgical drain was filled with blood. Immediate re-exploration was planned. IV anaesthetic agent of choice - and explain in detail?
Acute shock IV anesthetic agent of choice ketamine. Intravenous induction agent of choice in hypotension isketamine> etomidate. Ketamine helps to maintain aerial pressure, hea rate, and cardiac output due to central stimulation of the sympathetic nervous system and inhibition of the reuptake of norepinephrine Propofol if given , lead to worsening of shock due to the profound hypotensive action of propofol because of its vasodilatory and negative inotropic effects.