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Anaesth. pain intensive care. 2018; 22(3): 361-367


Comparative Study of Propofol Vs Etomidate as an Induction Agent to Evaluate Hemodynamic Changes during Induction of Anaesthesia in Controlled Hypertensive Patients

Jigna Shah, Ila Patel, Amrita Guha.




Abstract

Background and Aim: An ideal inducing agent for general anaesthesia should have hemodynamic stability, minimal respiratory side effects and rapid clearance. Presently there are a number of induction agents available. Present study was done with an aim to Comparison of propofol vs etomidate as an induction agent to evaluate hemodynamic changes during induction of anaesthesia in controlled hypertensive patient.
Material and Methods: A prospective randomized double blind study conducted at GMERS Medical College and hospital, Sola, Ahmedabad in 60 Patients who were undergoing surgeries under general anaesthesia during April 2015 to April 2016. Patients of group P will be given inj. fentanyl 2 µg/kg followed by Inj Propofol 1 -2 mg/kg, and patients of group E will be given inj. Fentanyl 2 µg/kg followed by Inj Etomidate 0.2- 0.4 mg/kg. Patient’s hemodynamic parameters like Systolic blood pressure, Diastolic blood pressure, Mean arterial pressure and Heart rate will be recorded at regular intervals in a table as shown in the data collection form. Any adverse event like pain during injection, myoclonus will be noted.
Results: Post-induction in etomidate group. heart rate did not significantly change compared to pre-induction But in propofol group, post induction heart rate significantly decreased compared to the pre-induction. In etomidate group, Post-induction, SBP did not change significantly as compared to preinduction. But in propofol group, SBP decreased significantly in postinduction. In etomidate group; post-induction DBP did not change significantly. But in propofol, DBP decreased after induction.
Conclusion: mean fall in HR at T2 in Group-E was 3.8% while that in Group- P was 6.5% .Etomidate maintains the heart rate stable for the complete duration of induction. The mean fall in SBP at T2 (3 minutes post induction) in Group-E Was 4.7% which was much less than that seen in Group-P (7.6%) . The fall in DBP in Group-P 3 minutes after induction was observed to be 16.24% as compared to Group-E being 4.8%.

Key words: Diastolic blood pressure, Hemodynamic changes, Systolic blood pressure, Propofol






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