A 6-month-old child is suffering from patent ductus arteriosus (PDA) with congestive cardiac failure. Ligation of ductus arteriosus was decided for surgical management. The most appropriate inhalational anesthetic agent of choice with minimal hemodynamic alteration fro induction of anesthesia is –
Correct Answer: Sevoflurane
Description: Ans. is 'b' i.e., Sevoflurane Sevoflurane is the agent of choice for inhalational induction of anesthesia in pediatric procedures.It is an excellent choice for smooth and rapid inhalational induction in pediatric procedures becauseIt has a sweet odor so induction is smoothThe rapid increase in alveolar anesthetic concentration (therefore rapid onset of action)It is low blood solubility's results in rapid fall in alveolar anesthetic concentration upon discontinuation and results in quicker emergence when compared to other inhalational agents.Cardiovascular effects of sevoflurane * Sevoflurane has minimal effect on cardiovascular system, it causes minimal hemodynamic alterations, therefore, it can be easily used as an induction agent in patients with PDA.The cardiovascular effects areMinimal cardiac depressionThe slight decrease in systemic vascular resistanceMinimal decrease in cardiac outputHalothane and isoflurane are usually avoided in children because they have a pungent odor and so the induction is not smooth.
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