What intravenous induction agent would be best to avoid in a patient with limited mouth opening and neck extension?

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Ketamine is the best intravenous induction agent to avoid in a patient with limited mouth opening and neck extension due to its potential for causing airway complications and its ability to stimulate secretions. When using ketamine, its dissociative properties may lead to complications during the induction phase, particularly in patients with restricted mouth opening, as they might struggle with airway management. This is particularly critical when intubation or other airway interventions may be necessary.

In scenarios where the patient has limited mouth opening, it's essential to choose an induction agent that facilitates easier airway management. Since ketamine can increase salivation and potentially complicate ventilation, avoiding it is prudent in this circumstance. Other agents like etomidate or propofol may offer smoother induction and better hemodynamic stability while not presenting the same challenges in managing the airway in such patients.

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