Ambulatory Anesthesia — MCQs

Ambulatory Anesthesia Indian Medical PG Practice Questions and MCQs

Question 31: The following combination of agents is preferred for short day care surgeries –

A. Propofol, fentanyl, isoflurane (Correct Answer)
B. Thiopentone sodium, morphine, halothane
C. Ketamine, pethidine, halothane
D. Propofol, morphine, halothane

Explanation: ***Propofol, fentanyl, isoflurane*** - This combination is preferred due to the **rapid onset and offset** characteristics of its components, which is crucial for **short day care surgeries**. - **Propofol** provides rapid induction and smooth maintenance, **fentanyl** offers effective analgesia with a short duration of action, and **isoflurane** allows for precise control of anesthesia depth with quick emergence. *Thiopentone sodium, morphine, halothane* - **Thiopentone social** has a slower recovery profile than propofol, which is less ideal for **day care surgery** settings. - **Morphine** has a longer duration of action and a higher incidence of postoperative nausea and vomiting compared to fentanyl. *Ketamine, pethidine, halothane* - **Ketamine** can cause significant psychomimetic side effects and a longer recovery time, making it less suitable for **short day care surgeries**. - **Pethidine** also has a longer duration of action and can lead to more problematic sedative effects post-operatively compared to fentanyl. *Propofol, morphine, halothane* - While **propofol** is an excellent choice for induction and maintenance, **morphine's** longer duration of action and potential for more significant postoperative side effects like nausea and vomiting make it less favorable for quick recovery in **day care surgery**. - **Halothane** is rarely used currently due to its association with **hepatotoxicity** and **cardiac arrhythmias**.

Question 32: Best anesthetic drug to be given in day-care surgery is:

A. Ketamine
B. Propofol (Correct Answer)
C. Sevoflurane
D. Fentanyl

Explanation: **Propofol** - **Propofol** is favored for day-care surgery due to its **rapid onset** and **short duration of action**, allowing for quick recovery and discharge. - It provides a **smooth induction** and emergence from anesthesia with a low incidence of postoperative nausea and vomiting (PONV). *Ketamine* - **Ketamine** can cause psychomimetic effects (e.g., hallucinations, vivid dreams) and **hypertension**, making it less suitable for day-care surgery where a rapid, clean recovery is desired. - Its longer recovery profile compared to propofol can delay patient discharge. *Sevoflurane* - While **sevoflurane** offers a rapid induction and recovery, its use in day-care surgery can be associated with a higher incidence of **postoperative nausea and vomiting (PONV)** compared to propofol, hindering quick discharge. - It requires an anesthesia machine for administration and reversal, which might be less efficient for quick turnovers compared to IV anesthetics. *Fentanyl* - **Fentanyl** is a strong opioid analgesic used primarily for pain control and as a supplement to general anesthesia, not as a primary anesthetic for induction and maintenance. - While effective for pain, its use alone would not provide adequate anesthesia for surgery and it can cause **respiratory depression** and delayed recovery if not used carefully, making it less ideal as the sole agent for rapid discharge.

Question 33: Which of the following intravenous induction agents is the most suitable for day-care surgery?

A. Morphine
B. Ketamine
C. Diazepam
D. Propofol (Correct Answer)

Explanation: ***Propofol*** - **Propofol** is an excellent choice for day-care surgery induction due to its **rapid onset** and **rapid recovery profile**, allowing for quicker patient discharge. - It also has a low incidence of **postoperative nausea and vomiting (PONV)**, which is crucial for patient comfort and discharge criteria in day-care settings. *Morphine* - **Morphine** is an opioid used primarily for pain management and not typically as a primary induction agent due to its slow onset and profound effects on respiration. - Its prolonged duration of action and potential for significant **postoperative respiratory depression** and **nausea/vomiting** make it unsuitable for day-care surgery. *Ketamine* - **Ketamine** is a dissociative anesthetic that can cause **psychomimetic side effects** (e.g., hallucinations, vivid dreams) during emergence, which are undesirable for day-care surgery. - It also has a longer recovery time and can lead to **increased heart rate and blood pressure**, posing challenges for rapid discharge. *Diazepam* - **Diazepam** is a benzodiazepine primarily used for sedation and anxiolysis, not as an sole induction agent for general anesthesia. - It has a **prolonged duration of action** and can cause significant **postoperative drowsiness** and cognitive impairment, delaying patient recovery and discharge from day-care surgery.

Practice by Chapter

Patient Selection for Ambulatory Surgery

Practice Questions

Preoperative Assessment for Outpatients

Practice Questions

Anesthetic Techniques for Ambulatory Surgery

Practice Questions

Fast-Track Recovery Protocols

Practice Questions

Post-Discharge Analgesia

Practice Questions

Preventing PONV in Outpatients

Practice Questions

Perioperative Management of Sleep Apnea

Practice Questions

Discharge Criteria

Practice Questions

Common Complications After Ambulatory Surgery

Practice Questions

Management of Diabetic Patients

Practice Questions

Geriatric Ambulatory Anesthesia

Practice Questions

Quality Improvement in Ambulatory Surgery

Practice Questions

Want unlimited practice?

Get full access to all questions, explanations, and performance tracking.

Start For Free