A patient with history of coronary aery disease presents with pulse rate of 48/min and low BP. Patient has decreased myocardial contractility on Echo. Which of these anesthetic agents is contraindicated?
Fentanyl
Etomidate
Ketamine
Dexmedetomidine
Ans: D. Dexmedetomidine(Ref KDT 7/e p384; Katzung 13/e p I 45, 12/e p445)This case patient has bradycardia & hypotension.Hence, Dexmedetomidine is contraindicated in hypovolemia, hypotension, hea block and congestive hea failure.Dexmedetomidine - Side effects:Similar to those with clonidine (hypotension, bradycardia & dry mouth ).Contraindications:Hypovolemia.HypotensionHea block.CHF prior to administration.