PROSPECTIVE ANALYTICAL OBSERVATIONAL STUDY OF HAEMODYNAMIC STABILITY OF INJECTION ETOMIDATE AND INJECTION PROPOFOL FOR INDUCTION OF GENERAL ANAESTHESIA IN ELECTIVE SURGERIES
Dr. Nida Shaikh, Dr. Prakash Dhumal and *Dr. Anushree Chaudhari
Introduction: Etomidate produces dependable, fast onset of anaesthesia and is perceived as having a favourable haemodynamic profile, making it a commonplace preference for patients vulnerable to hypotension, or wherein hypotension is undesirable. This study was conducted to evaluate the effect of injection Etomidate and injection Propofol on haemodynamics during and after induction of general anaesthesia. Methods: After taking approval from institutional ethics committee and written informed consent from all patients, 70 ASA I-II class patients, 18-85 years old, both male and female posted for elective surgeries were included in the study. Standard noninvasive monitors were attached. Inj glycopyrolate 4mcg/kg iv, inj midazolam 0.02mg/kg iv and inj pantazocine 0.3mg/kg iv. were given. Preoxygenation was done for 3 min and patients were randomly divided into group E induced with injection Etomidate(0.3mg/kg) iv and group P induced with injection Propofol (2mg/kg) iv. After loss of eyelash reflex, inj succinylcholine 1.5mg/kg was given iv and intubation done after 60 secs. Heart rate(HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) were recorded at baseline, 0min(intubation), 1min, 2min, 3min, 5min, and 10min and changes were compared in both the groups. Percentage increase or decrease was calculated by (Baseline value – Values at specific intervals)*100/ Baseline value.Chi-square test was used as test of significance for qualitative data.Independent t test was used as test of significance for quantitative variables. P value of <0.05 was considered as statistically significant. Results: The mean HR, percentage increase of HR was significantly higher in group P from 0-10min. The mean SBP, DBP and MAP were significantly lower in P at 5 to 10 min, 3 to 10min and 3 to10 min after intubation respectively and the mean percentage change in SBP, DBP and MAP was significantly lower in P from 3 to 10 min, 2 to 10min and 2 to 10 min respectively indicating significant hypotension in this group. Conclusion: Injection Propofol at 2mg/kg iv caused significant hypotension and tachycardia as compared to 0.3mg/kg iv of inj Etomidate making Etomidate the better choice as compared to propofol for induction of general anaesthesia in terms of hemodynamic stability.
Keywords: etomidate, induction agent, hemodynamic stability.
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