A 28-year-old man presents with a penetrating globe injury requiring emergency repair. He is otherwise healthy and fasting status is adequate. Which induction agent should be avoided because of its effect on intraocular pressure?
- A Propofol
- B Ketamine ✓
- C Etomidate
- D Thiopentone
Correct answer: B. Ketamine
Explanation
Ketamine raises intraocular pressure through extraocular muscle contraction and increased choroidal blood flow, so it is traditionally avoided in open globe injury where extrusion of vitreous is feared. Propofol, thiopentone and etomidate all lower intraocular pressure, making them acceptable choices here. Although some recent literature questions the magnitude of this rise with low doses, standard Indian examination teaching retains raised IOP as a relative contraindication to ketamine in open eye injuries.
Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.