Which anaesthetics have the safest cardiac safety profile?

The choice identifying ketamine and etomidate as having the safest cardiac safety profile is grounded in their pharmacological properties and effects on the cardiovascular system.

Ketamine, an NMDA receptor antagonist, is known for its unique analgesic and dissociative properties. It maintains hemodynamic stability, often causing increased heart rate and blood pressure, making it favorable in patients with compromised cardiovascular function. This makes it particularly advantageous in emergency settings or in patients who may not tolerate hemodynamic fluctuations well.

Etomidate primarily serves as a sedative-hypnotic agent used for induction in anesthesia. It has minimal cardiovascular effects; it does not significantly affect heart rate or blood pressure, making it one of the safest choices for patients with cardiovascular instability.

In contrasting the other combinations, sodium thiopental and propofol, while effective anesthetics, can lead to cardiovascular depression, particularly with rapid administration or in patients with pre-existing heart conditions. Propofol, while popular for its rapid onset and antiemetic properties, does cause vasodilation which can result in hypotension, especially in susceptible populations.

Choosing between ketamine and etomidate compared to other combinations points to a clearer cardiac safety profile, as both agents do not significantly impede cardiovascular