Cross Sectional Observational Study of Cardiovascular Response After Propofol and Etomidate Anaesthesia Induction (original) (raw)
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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.
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.
International journal of health sciences
Introduction: Laryngoscopy and endotracheal intubation are harmful stimuli that can produce adverse response in the cardiovascular, respiratory and other physiological systems. These changes are reflected in haemodynamic parameters which can be fatal for patients with low cardiac reserve and may alter the balance between myocardial oxygen supply and demand and as a result, myocardial ischemia can be precipitated. This observational comparative study was conducted to compare the haemodynamic effects of Propofol and Etomidate during induction of general anaesthesia in patients scheduled for elective surgery. Materials and Methods: 58 patients of American Society of Anaesthesiologists (ASA) physical status I and II of age group 18-60 years scheduled for elective surgeries under general anaesthesia were randomly assigned in two groups (n=28). Group P received injection Propofol (2.5mg/kg) and group E received injection Etomidate (0.3mg/kg) during induction. Hemodynamic parameters were ...
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...
Academia Anesthesiologica International, 2019
Background: Hemodynamic stability during laryngoscopy and intubation with minimal side effects is the main objective of any anaesthetist. The present study was conducted to assess hemodynamic effects of etomidate versus propofol in elective surgical patients. Subjects and Methods: The present study was conducted on 48 patients planned for elective surgery of both genders. Patients were divided into 2 groups of 24 each. Group I patients were given propofol (P) and group II were given the etomidate. Parameters were recorded. Results: The mean height in group I patients was 165.2 cm and in group II was 166.7 cm, mean weight was 68.1 kg in group I and 65.2 kg in group II. Mean MAP (mm Hg) at T1 in group I was 118, T2 was 90, T3 was 102 and T4 was 106. In group II, T1 was 110, T2 was 94, T3 was 98 and T4 was 100. The difference was non-significant (P> 0.05). Mean HR (beats/min) at T1 in group I was 77.2, T2 was 79.4, T3 was 81.5 and T4 was 79.1. In group II at T1 was 75.4, T2 was 81.6, at T3 was 87.2 and at T4 was 84.3. No statistical significance was observed in between both the groups on comparing Heart Rate and Mean Arterial Pressure. Conclusion: Both Etomidate and Propofol are equally effective in terms of their hemodynamic effects.
Journal of cardiovascular and thoracic research, 2013
LMA is a simple supra-laryngeal device which is used to establish and maintain airway. Despite the common use of the LMA, there are no optimal methods for induction of anesthesia that can guarantee a proper insertion. The purpose of this study is comparing three methods of induction of anesthesia (Propofol, Etomidate, Propofol+Etomidate) in the hemodynamic stability after LMA insertion in elective surgeries. A total of 90 patients with ASA classes I and II undergoing elective surgeries were randomly allocated into one of the following three groups. Before anesthesia induction, all patients were premedicated. Anesthesia induction methods included: Group P (propofol 2.5 mg/kg), Group E (etomidate 0.3 mg/kg) and Group P+E (propofol 1 mg/kg plus etomidate 0.2 mg/kg). Heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were measured before induction and 30 seconds after induction. Apnea time is recorded in all patients. Number of attempts to laryngea...
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...
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.
Anesthesiology and Pain Medicine, 2016
Background: Laryngoscopy and intubation frequently used for airway management during general anesthesia, is frequently associated with undesirable hemodynamic disturbances. Objectives: The aim of this study was to compare the effects of etomidate, combination of propofol-ketamine and thiopental-ketamine as induction agents on hemodynamic response to laryngoscopy and intubation. Patients and Methods: In a double blind, randomized clinical trial a total of 120 adult patients of both sexes, aged 18-45 years, scheduled for elective surgery under general anesthesia were randomly assigned into three equally sized groups. Patients in group A received etomidate (0.3 mg/kg) plus normal saline as placebo. Patients in group B and C received propofol (1.5 mg/kg) plus ketamine (0.5 mg/kg) and thiopental sodium (3 mg/kg) plus ketamine (0.5 mg/kg), respectively for anesthesia induction. Before laryngoscopy and tracheal intubation, immediately after, and also one and three minutes after the procedures, hemodynamic values (SBP, DBP, MAP and HR) were measured. Results: A repeated measurement ANOVA showed significant changes in mean SBP and DBP between the time points (P < 0.05). In addition, the main effect of MAP and HR were statistically significant during the course of study (P < 0.05). Furthermore, after induction of anesthesia, the three study groups had significantly different SBP, DBP and MAP changes overtime (P < 0.05). However, HR changes over time were not statistically significant (P > 0.05). Combination of propofol-ketamine had superior hemodynamic stability compared to other induction agents. Conclusions: Combination of propofol-ketamine may be recommended as an effective and safe induction agent for attenuating hemodynamic responses to laryngoscopy and intubation with better hemodynamic stability. Although, further well-designed randomized clinical trials to confirm the safety and efficacy of this combination, especially in critically ill patients or patients with cardiovascular disease, are warranted.
Propofol or etomidate: Does it genuinely matter for induction in cardiac surgical procedures
2016
In the present study we compared propofol with etomidate in cardiac surgical procedures, in order to determine suitability of each agent for induction. Aims: To compare propofol with etomidate with respect to hemodynamic stability during induction of anesthesia. Settings and design: This prospective randomized study was carried out on 60 patients admitted for open cardiac surgical procedures. Methods: The patients undergoing elective cardiac surgeries both on pump and off pump surgeries were randomly assigned to one of the two study groups, each group consisting of 30 patients. Statistical analysis: The observations in both the groups were recorded. Statistical analysis was done using SPSS version 20, student's t test and chi square test. Results: Fall in heart rate was more in propofol group. Hemodynamic stability was better in etomidate group. Conclusion: Etomidate is a better agent in cases with limited cardiac reserve when compared to propofol. However both agents can be appropriate for induction of anesthesia in cardiac surgical procedures, if given judiciously.