A 28-year-old woman with severe bronchial asthma (FEV1 35% predicted, frequent exacerbations) is scheduled for emergency appendicectomy under general anaesthesia. She has been wheezing despite nebulised salbutamol. Which induction agent is MOST appropriate?
- A Thiopentone sodium
- B Ketamine ✓
- C Propofol
- D Etomidate
Correct answer: B. Ketamine
Explanation
Ketamine is the preferred induction agent in severe active asthma because it causes direct bronchodilation via sympathetic stimulation and catecholamine release, while also providing analgesia. Thiopentone can precipitate histamine release and bronchospasm. Propofol has some bronchodilating properties but is less reliable in the setting of active wheeze than ketamine.
Reference: Miller's Anaesthesia, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.