What can you combine with propofol for induction?

• A. Ketamine, midazolam
• B. Fentanyl, thiopental
• C. Etomidate, fentanyl
• D. Propofol alone

Answer: (A)

Combining propofol with agents that provide analgesia and amnesia helps create a smoother, balanced induction. Propofol alone drives hypnosis quickly but lacks analgesia and can cause significant drops in blood pressure and breathing suppression. Ketamine brings analgesia and dissociative anesthesia and tends to support blood pressure, helping counteract propofol’s cardiovascular depression. Midazolam adds anxiolysis and amnesia, making the induction more tolerable and often allowing you to use a smaller propofol dose. Together, propofol plus ketamine and midazolam gives you adequate hypnosis, pain control, and hemodynamic stability, which is why this combination is favored for induction.