A 38 year old man is posted for extraction of last molar tooth under general anaesthesia as a day care case. lie wishes to resume his work after 6 hours. Which one of the following induction agents is preferred?
First, I need to recall the commonly used induction agents. The options might include things like propofol, etomidate, ketamine, and thiopental. Since the correct answer is missing, I'll have to figure out based on the scenario.
Day care procedures require agents that have a quick recovery time to allow patients to return home or work safely. Propofol is known for rapid onset and short duration, which is ideal for short procedures. It also has antiemetic properties, reducing post-op nausea, which is common after dental surgeries. Thiopental, on the other hand, has a longer duration and might lead to prolonged sedation. Etomidate is good for preserving hemodynamics but has a slower recovery. Ketamine might cause emergence delirium and is less favored for quick recovery.
The key here is the rapid recovery needed for the patient to go back to work. Propofol would be the best choice. The other agents either have longer durations or side effects that delay recovery. So the correct answer is propofol.
**Core Concept**
This question assesses knowledge of **induction agents for general anesthesia** in outpatient procedures. The ideal agent must provide rapid onset, short duration, minimal side effects, and quick recovery to ensure patient safety for resuming activities postoperatively.
**Why the Correct Answer is Right**
**Propofol** is the preferred induction agent here due to its **rapid onset (30-60 seconds)**, **short context-sensitive half-life (2-10 minutes)**, and **minimal postoperative residual sedation**. It is metabolized by the liver via ester hydrolysis, producing inactive metabolites excreted by the kidneys. Its antiemetic properties also reduce postoperative nausea, common in dental procedures. This aligns with the patient’s goal to return to work within 6 hours.
**Why Each Wrong Option is Incorrect**
**Option A: Thiopental** – A barbiturate with prolonged recovery time and risk of prolonged sedation, increasing postoperative confusion.
**Option B: Etomidate** – Preserves hemodynamics but causes adrenal suppression with repeated use and slower recovery compared to propofol.
**Option C: Ketamine** – Causes emergence delirium and vivid dreams, delaying safe discharge.
**Clinical Pearl / High-Yield Fact**
Propofol is the **gold standard for outpatient anesthesia** due to its rapid recovery profile. Avoid ketamine in cases requiring quick return to normal activities. Remember: **“Propofol = Pop and go!”** for day-case surgeries.
**Correct Answer: C. Propofol**