Comparison of haemodynamic response to induction with propofol versus etomidate in patients scheduled for elective surgery (original) (raw)
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IP Innovative Publication Pvt. Ltd., 2018
Aims and Objectives: Propofol and etomidate are most frequently used intravenous induction agents, with very similar onset of action and duration of action, few advantages over each other and few unwanted effects. Recent studies and reintroduction of etomidate has paved way for its routine use in haemodynamically unstable patients. Materials and Methods: One hundred patients belonging to American Society of Anaesthesiologists (ASA) class I and II, aged between 18 to 60 years scheduled to undergo elective surgical procedure under general anaesthesia were selected. All the patients received tablet diazepam 0.2 mg/kg as premedication and fentanyl 2 mcg/kg body weight before induction. Patients were be randomly allocated to group P ((n = 50), who received propofol 2 mg/kg or group E (n = 50) who received, Etomidate 0.3 mg/kg as induction agent for general anaesthesia. Endotracheal intubation was facilitated by vecuronium 0.1mg/kg body weight. Heart rate (HR), Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were recorded at basal, after fentanyl, 1, 3, 5 and 10 min following induction. Results: There was no significant change in the heart rate at and after the induction, intubation in either group P or group E. There was significant decrease in SBP, DBP and MAP in group P following induction, whereas there was less decrease in Group E. There was increase in the SBP, DBP and MAP after intubation in both the groups, but in group P it did not increase above the basal and remained below the basal levels at 5 and 10 minutes following intubation. Conclusion: Etomidate provides stable haemodynamics at induction of general anaesthesia. But it does not attenuate the haemodynamic response to laryngoscopy and intubation. Propofol causes significant hypotension at induction and attenuates the pressor response to laryngoscopy and intubation. Keywords: Propofol, Etomidate, Haemodynamic, Laryngoscopy, Blood pressure.
innovative publication
Context: Etomidate is having more stable cardiovascular response as compared to propofol during laryngoscopy and intubation. Aims: The present study compares the effect of propofol and etomidate on cardiovascular response to laryngoscopy and intubation. Settings and Design: This prospective comparative study was conducted at a tertiary care hospital in central India. Methods and Material: Hundred healthy patients of both sex aged between 18 to 45 years, ASA physical status I & II, scheduled for elective surgery under general anaesthesia were selected. Patients in group P (n=48) were induced with propofol 2.5 mg/kg i.v. and group E (n=47) were induced with etomidate 0.3 mg/kg i.v. Patients' haemodynamic and cardiovascular parameters were recorded before induction (T1), before intubation (T2) and 1, 3, 5 and 10 minutes afterwards. The haemodynamic parameters before induction i.e. T1 was taken as baseline. Statistical analysis used: The data was collected using Microsoft Excel software and was analysed using SPSS software version17.0. Results: There was significant difference regarding systolic blood pressure, diastolic blood pressure and mean arterial pressure among two groups. Hypotension was seen in 18.8% patients in group P after induction while there was none in group E. Conclusions: Etomidate is having more stable cardiovascular response as compared to propofol during laryngoscopy and intubation.
International journal of health sciences
Etomidate and propofol are two common anaesthetic drugs. Etomidate can be used in patients with little hemodynamic reserve, whereas Propofol can result in more hemodynamic instability, according to prior research. During the induction of anaesthesia with Etomidate or, as a comparison, Propofol in elective surgeries, the cardiovascular response was examined in this study. Patients who were admitted for elective surgeries and ranged in age from 18 to 60 were included in this cross-sectional observational study. The cardiovascular responses of 50 (47) patients were assessed prior to induction, after the induction of anaesthesia with drugs, and at 1, 3, 5, and 10 minutes following the laryngoscopy. These measurements included systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and O2 saturation (O2 sat). In terms of patient gender, age, and weight, there were no statistically significant differences between the two groups. At dif...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND An ideal induction agent for general anaesthesia should have haemodynamic stability, minimal respiratory side effects and rapid clearance. Sudden hypotension has a deleterious effects on maintaining the circulation to vital organs. Presently, etomidate and propofol are popular rapid acting inducing agents. Hence, this study was conducted to compare the haemodynamic effects of etomidate and propofol. MATERIALS AND METHODS Double-blind randomised study was conducted on sixty patients after informed consent comprising of thirty patients each (Group E for etomidate and group P for propofol). Patients were premedicated with Inj. Glycopyrrolate 0.2 mg IV, Inj. Butorphanol 0.03 mg/kg IV, Inj. Midazolam 0.3 mg/kg IV followed by etomidate 0.3 mg/kg given slowly over 45 seconds in the group E and propofol 2 mg/kg for induction of anaesthesia in the group P. Heart rate and blood pressure were measured before induction and every minute for 3 minute after induction. RESULTS When compared to etomidate group, there was a significant fall in blood pressure in propofol group. There was no significant change in hearts rate in all three groups. CONCLUSION When etomidate is used as an induction agent during general anaesthesia, there is a better haemodynamic stability in comparison to propofol.
Comparison between Propofol and Etomidate for Induction of General Anaesthesia
2020
Introduction: During induction of general anaesthesia, there is a possibility of haemodyanamicvariabilities especially in patients with cardiovascular risk factors and those with haemodyanamic instability. So, a safe induction agent with fewer adverse effects is desirable. In the present study we intend to compare propofol and etomidate for their effect on haemodyanamic response to laryngoscopy and intubation and other adverse effects. METHODS: 80 patients in the age group 20 to 60 years, ASA class I and II, posted for elective surgeries were divided into two groups (group P and group E) of 40 each. Group P received propofol 2mg/kg and group E received etomidate 0.3mg/kg for induction. Haemodyanamic parameters at induction, laryngoscopy and then upto 5 minutes post intubation were recorded and compared. Pain on injection and myoclonus were also observed in both groups. RESULTS: Baseline parameters were comparable for both groups. In the etomidate group, less variability in heart rat...
Medical Journal of Shree Birendra Hospital
Introduction: While most intravenous induction agents decrease arterial blood pressure, laryngoscopy and endotracheal intubation increase the heart rate and blood pressure. Propofol causes a decrease in systemic blood pressure whereas etomidate has minimal effects on the cardiovascular system. This study aims to evaluate and compare the hemodynamic effects of propofol and etomidate during induction and endotracheal intubation. Methods: 62 ASA I and II patients, 20-60 years of age, scheduled for elective surgery were enrolled in this prospective, randomised and double blind comparative study. Group A received inj. Propofol (2 mg/kg) and group B received inj. Etomidate (0.3 mg/kg), as induction agents. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were recorded after induction and after intubation at one, three, five and ten minutes and intergroup comparisons were made. Results: After induction the decrease in systolic, diastolic and th...
Advanced biomedical research, 2014
Laryngoscopy and endotracheal intubation can induce unfavorable hemodynamic changes as propofol itself can induce hypotension. The aim of this study was to compare the effects of three different additional doses of propofol infusion on intubation conditions and hemodynamic changes occurred after intubation. This double-blinded prospective study was performed on 140 patients aged 18-60 who received different additional doses of propofol and were randomly allocated into 4 groups as follows: A: Received additional dose of propofol 0.5 mg/kg infused after an initial dose 1.5 mg/kg. B: Received additional dose of propofol 1 mg/kg infused after an initial dose 1 mg/kg. C: Received additional dose of propofol 1.5 mg/kg after an initial dose 1 mg/kg. D: Received propofol 2 mg/kg as a bolus with no additional dose. Intubation conditions were acceptable in 91.4% of Group A patients, 94.2% of Group B patients, 97.1% of Group C patients and 68.5% of Group D patients. There were no significant d...
Journal of Evidence Based Medicine and Healthcare, 2021
BACKGROUND Laryngoscopy and endotracheal intubation, a painful procedure, frequently used in airway management is commonly associated with undesired haemodynamic changes like hypertension, tachycardia and arrythmias. Thus, this study was designed to compare haemodynamic stability to laryngoscopy and intubation using single drug induction with etomidate and combined drug induction with propofol and ketamine. METHODS This was a double blind randomised controlled trial, a total of 90 patients of both sexes, aged between 18 - 60 years, who were scheduled for elective surgeries under general anaesthesia in regional institute of medical sciences (RIMS) operation theatre (OT) were divided into two groups. Group PK received propofol (1.5 mg / kg) + ketamine (0.5 mg / kg) and Group E received etomidate (0.3 mg / kg) as induction agents. The haemodynamic parameters (systolic blood pressureSBP, diastolic blood pressure-DBP, mean arterial pressure-MAP, heart rate-HR) were recorded before induct...
2021
The changes in heart rate and blood pressure are of no consequence and are well tolerated by healthy individuals. But in patients with hypertension, heart disease and coronary artery disease, the pressor response can result in an increase in the cardiac work load. The pressor response also assumes a higher significance in neurosurgical patients. This study was conducted on 100 patients. They were allotted into two groups, comprising of 50 patients in each group. IV line secured for all patient. All patients were premeditated with injection fentanyl 1µg/kg and glycopyrrolate 0.2mg iv 10min before induction. The mean baseline SBP of the etomidate group was 124.48 ± 13.75 and the mean baseline SBP in the propofol group was 127.14 ± 8.77. The p value after inter-group comparison is 0.0990, which is statistically insignificant suggesting that both groups were comparable at the start of study.
A comparative study between propofol and etomidate in patients under general anesthesia
Brazilian Journal of Anesthesiology (English Edition), 2016
Background and objectives: Induction of anesthesia is a critical part of anesthesia practice. Sudden hypotension, arrhythmias, and cardiovascular collapse are threatening complications following injection of induction agent in hemodynamically unstable patients. It is desirable to use a safe agent with fewer adverse effects for this purpose. Present prospective randomized study is designed to compare propofol and etomidate for their effect on hemodynamics and various adverse effects on patients in general anesthesia. Methods: Hundred ASA I and II patients of age group 18-60 years scheduled for elective surgical procedure under general anesthesia were randomly divided into two groups of 50 each receiving propofol (2 mg/kg) and etomidate (0.3 mg/kg) as an induction agent. Vital parameters at induction, laryngoscopy and thereafter recorded for comparison. Adverse effect viz. pain on injection, apnea and myoclonus were carefully watched. Results: Demographic variables were comparable in both the groups. Patients in etomidate group showed little change in mean arterial pressure (MAP) and heart rate (HR) compared to propofol (p > 0.05) from baseline value. Pain on injection was more in propofol group while myoclonus activity was higher in etomidate group. Conclusions: This study concludes that etomidate is a better agent for induction than propofol in view of hemodynamic stability and less pain on injection.