Abstract

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. Present prospective randomized study is designed to compare propofol and etomidate for their effect on hemodynamics in patients undergoing 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.

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.

Conclusions: This study concludes that etomidate is a better agent for induction than propofol in view of hemodynamic stability.

• 1.   Stoelting Robert and Simon C. Hiller. Pharmacology and Physiology in Anesthetic practice. 5th edition. Philadelphia: Lippincott Williams and Wilkins publishers.2015;160-171.
• 2.   Ebert TJ, Muzi M, Berens R, et al. Sympathetic responses to induction of anesthesia in humans with Propofol or Etomidate. Anesthesiology 1992;76:725- 733.
• 3.   Sarkar M, Laussen PC, Zurakowski D, et al. Hemodynamic responses to Etomidateon induction of anesthesia in paediatric patients. Anesthesia Analgesia. 2005;101:645-650.
• 4.   Morel J, Salard M, Castelain C, et al. Haemodynamic con-sequences of Etomidate administration in elective cardiac surgery: a randomized double-blinded study. British Journal of Anesthesia.2011;107:503-9.
• 5.   Paris A, Philipp M, Tonner PH, et al. Activation of alpha2B-adrenoceptors mediates the cardiovascular effects of Etomidate. Anesthesiology. 2003;99:889-95.
• 6.   Kim TK, Park IS. Comparative study of brain protection effect between thiopental and Etomidate using bispectral index during temporary arterial occlusion. J Korean Neurosurg Soc.2011; 50:497-502.
• 7.   Giese JL, Stockham RJ, Stanley TH, Pace NL, Nelissen RH. Etomidate versus thiopental for induction of anesthesia. Anesthesia Analgesia 1985;64:871-6.
• 8.   R. Carlos, S. Innerarity. Effect of Premedication on Etomidate Anesthesia. British Journal of Anesthesia. 1979;51:1159
• 9.   J. G. Reves, Peter Glass, David A. Lubarsky. In: Ronald D Miller, editors. Miller’s Anesthesia. 7th ed. Philadelphia: Churchill Livingstone Elsevier; 2005. P.719-769.
• 10.   Ebru Kelsaka, Deniz Kara kaya, Binnur Sarihasan et al. Remifentanil pretreatment reduces myoclonus after Etomidate. Journal of clinical anesthesia 2006;18:83-86.
• 11.   Ram Prasad Kaushal, Ajay Vatal, et al Effect of etomidate and propofol induction on hemodynamic and endocrine response in patients undergoing coronary artery bypass grafting/mitral valve and aortic valve replacement surgery on cardiopulmonary bypass. Annals of Cardiac Anesthesia 2015; 18(2):172-178
• 12.   Anil Kumar Pandey, Neeti Makhija, et al. The Effects of Etomidate and Propofol Induction on Hemodynamic and Endocrine Response in Patients UndergoingCoronary Artery Bypass Graft Surgery on Cardiopulmonary Bypass .World Journal of Cardiovascular Surgery 2012;2:48-53 .
• 13.   Criado A, Maseda J, Navarro E, et al. Induction of anesthesia with Etomidate: Haemodynamic study of 36 patients.
• 14.   Gooding, j. M., Weng, j.-T., Smith, r. A., Berninger, g. T., And kirby, r. R.: Cardiovascular and pulmonary responses following etomidate induction of anesthesia in patients with demonstrated cardiac disease. Anesthesia Analgesia 58:40-41, 1979.

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