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A Study on Hemodynamic Response During Induction with Etomidate, Propofol or Combination of Etomidate and Propofol in General Anaesthesia

Vasantha Kumar J , Vasantha Kumar J , Lubna

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Indian Journal of Anesthesia and Analgesia 7(1):p 368-374, January-February 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.50

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Vasantha Kumar J, Lubna. A Study on Hemodynamic Response During Induction with Etomidate, Propofol or Combination of Etomidate and Propofol in General Anaesthesia. India J Anesth Analg. 2020;7(1 Part -II):368-374.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Introduction: Patient’s safety is the most important aspect of patient management in general anesthesia. Stress response during laryngoscopy and intubation leads to hemodynamic changes. In all the methods used for induction of anesthesia, it is aimed to preserve the hemodynamic balance and to provide optimal conditions by reducing the side effects. The purpose of this study was to compare hemodynamic response during induction with propofol, etomidate or combination of propofol and etomidate with special reference to pain on injection and myoclonus in patients requiring endotracheal intubation in elective surgeries. Materials and Methods: It is a prospective randomized comparative study. After getting ethical committee clearance, a group of ninety patients aged 18 to 65 years of either sex and ASA physical status I or II scheduled for elective surgery under general anesthesia were assigned randomly to Three Groups Group (P) was induced with Injection. Propofol (2 mg/kg) intravenously Group (E) with Injection. Etomidate (0.3 mg/kg) intravenously and Group (P + E) with Injection. Propofol (1 mg/kg) plus Injection. Etomidate (0.15 mg/kg) intravenously. Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Blood Pressure (MAP) and Oxygen Saturation (SpO2) were noted at different time intervals. Presence of pain on injection and myoclonus were also observed. Statistical Analysis: Data will be analyzed by descriptive Statistics. Student’s t-test was used to compare the significant difference between two means. ANOVA for three groups. The Chisquare test was used for categorical data such as gender, American Society of Anesthesiologist physical status, injection pain and myoclonus. A value of p <0.05 is considered as statistically significant. Results: There was significant difference in mean HR (p < 0.001) between the 3 groups within 1–5 minutes of induction. MAP among all three groups decreases after induction and it was more in Group P than in Group E and Group P + E. The incidence of myoclonus in Group E was 80% while in Group P + E was 1.3% and none in Group P. The incidence of pain on injection in Group P was 86.7%, Group E was 10% and none in Group P + E. Conclusion: The incidence of hemodynamic instability, pain on injection, myoclonus is less with E + P group. Therefore, we concluded that combination of etomidate & propofol can be considered as valuable alternative as an induction agent.

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Cite this article

Vasantha Kumar J, Lubna. A Study on Hemodynamic Response During Induction with Etomidate, Propofol or Combination of Etomidate and Propofol in General Anaesthesia. India J Anesth Analg. 2020;7(1 Part -II):368-374.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.50

Keywords

Etomidate; Propofol; Hemodynamics; Injection Pain; Myoclonus.

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