Thiopentone is contraindicated in –
**Core Concept**
Thiopentone, a barbiturate anesthetic, is a rapidly acting agent used for induction of general anesthesia. However, its use is contraindicated in certain conditions due to its pharmacological properties. Thiopentone can cause a decrease in cerebral metabolic rate and cerebral blood flow, which can lead to a decrease in intracranial pressure. However, in some cases, this effect can be detrimental.
**Why the Correct Answer is Right**
The correct answer is related to the effect of thiopentone on the cardiovascular system and intracranial pressure. Thiopentone can cause a decrease in systemic vascular resistance and cardiac output, which can lead to hypotension. In patients with a head injury or increased intracranial pressure, thiopentone can cause a further decrease in cerebral perfusion pressure, leading to cerebral ischemia. Therefore, thiopentone is contraindicated in patients with a head injury or increased intracranial pressure.
**Why Each Wrong Option is Incorrect**
* **Option A:** Thiopentone is not contraindicated in patients with asthma. In fact, thiopentone can be used as an anesthetic agent in patients with asthma, as it does not trigger bronchospasm.
* **Option B:** Thiopentone is not contraindicated in patients with severe renal failure. Thiopentone is primarily metabolized by the liver and excreted by the kidneys, but its clearance is not significantly affected by renal failure.
* **Option C:** Thiopentone is not contraindicated in patients with severe cardiac disease. While thiopentone can cause a decrease in cardiac output, it is not contraindicated in patients with severe cardiac disease.
**Clinical Pearl / High-Yield Fact**
Remember that thiopentone can cause a decrease in cerebral metabolic rate and cerebral blood flow, which can lead to a decrease in intracranial pressure. However, in patients with a head injury or increased intracranial pressure, thiopentone can cause a further decrease in cerebral perfusion pressure, leading to cerebral ischemia.
**Correct Answer:** C.