Comparison of cardiovascular response to laryngoscopy and tracheal intubation after induction of anesthesia by Propofol and Etomidate

Mehrdad Masoudifar, Elham Beheshtian


Background: Etomidate and Propofol are common anesthetic agents. Previous studies say that Etomidate can be used in patients
with limited hemodynamic reserve and Propofol can lead to more hemodynamic instabilities. Th is study was performed to explore
the cardiovascular response during the induction of anesthesia with Etomidate or for comparison, Propofol in elective orthopedic
surgeries. Materials and Methods: Th is study was a double-blinded randomized clinical trial study including patients 18-45 years of
age that were admitted for elective orthopedic surgeries in 2012. 25consenting, ASA I (American Society of Anaesthesiologists), patients
were evaluated randomly in two groups, and their cardiovascular responses including: systolic blood pressure (SBP), diastolic blood
pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and O2 saturation (O2 sat) were measured before the laryngoscopy,
during the anesthesia induction with Etomidate (0.3 mg/kg) in group A and propfol (2-2.5 mg/kg) in group B and at 1, 3, 5,10 min
after the induction. Results: Th ere were no statistical diff erences between both groups regarding gender, age, body mass index, and
laryngoscopic grade of patients (P > 0.05). Changes of SBP in the group B was signifi cantly higher (P = 0.019). Furthermore, changes
of the DBP was signifi cantly higher in the group B (P = 0.001). Th e changes of MAP was higher in group B (P = 0.008). Hypotension happened in 26.1% of group B and 8% of group A (P = 0.09). Th ere were no signifi cant diff erences among groups A and B in terms of HR (P = 0.47) and O2 sat (P = 0.21), tachycardia (P = 0.6), bradycardia (P = 0.66) and hypertension (P = 0.95). Conclusion: Since,patients receiving Etomidate have more stable hemodynamic condition, if there would be no contraindications, it could be preferred
over Propofol for general anesthesia.

Key words: Cardiovascular response, etomidate, hemodynamic changes, laryngoscopy, propofol

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