Comparative Study of Etomidate and Midazolam with Fentanyl as Inducing Agents in Patients Undergoing Off-pump Coronary Artery Bypass Graft Surgery

Shukla, Nidhi; Kushwaha, Brij Bihari; Kausal, Dinesh; Singh, Vinita; Singh, Sushil Kumar; Devenraj, Vijayant; Chaudhary, Ajay Kumar; Singh, Prithvi

doi:10.7860/jcdr/2018/29105.11499

Cited by 1 publication

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“…Thereafter SBP, DBP and MAP returned slowly around baseline at post intubation 15 min.in both the groups. These observations are consistent with Kaushal RP et al, 11 Kamath MN et al, 16 Sivanna S et al, 18 and Shukla N et al 19 The observations of Singh R et al 14 are dissimilar to the present study as they concluded that both anesthetic agents were acceptable for induction in patients with coronary artery disease and left ventricular dysfunction despite a 27-32% decrease in the mean arterial pressure and the outcome of anesthetic induction may depend on factors such as the speed of injection, route, dose and experience of the clinician, other than the property of the agent itself.…”

Section: Hemodynamic Parameterssupporting

confidence: 86%

Comparison of hemodynamic effects of etomidate and propofol as an induction agent in patients with LVEF 40% undergoing elective coronary artery bypass grafting surgery – A prospective and randomized study

Carpenter¹,

Soni²,

Goyal³

et al. 2021

IJCA

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This study aims to compare the hemodynamic response of two commonly used induction agents Propofol and Etomidate in patients with left ventricular ejection fraction ≤40% undergoing Coronary Artery Bypass Grafting surgery. To compare the effects of Propofol and Etomidate on hemodynamics in terms of heart rate, rhythm, blood pressure, and central venous pressure. Narayana Multispeciality Hospital, Jaipur. Prospective, double-blinded, randomized, hospital based study.100 patients with LVEF≤40% scheduled for elective CABG, were randomly assigned to one of the two groups receiving either of the inducing agents, group A (PROPOFOL 2mg/kg) and group B (ETOMIDATE 0.2mg/kg). Unpaired t-test and Chi square test/Fisher exact test, p<0.05 was taken as significant. HR, SBP, DBP and MAP decreased from post induction 1 min. to post induction 3 min. (fall greater in propofol, p>0.005) then increased from post intubation 1 min. to post intubation 5 min. in both the groups (rise greater in etomidate group, p<0.005). Need of drugs to control hypotension (62% and 26%, p=0.001) and to control pressor response (10% and 38%, p=0.002) was observed in both the groups. Etomidate is superior to propofol in providing hemodynamic stability before and after laryngoscopy and intubation, but less effective in controlling the pressor response to intubation. Therefore, Etomidate can be used as an induction agent with suitable adjuvants to control pressor response to tracheal intubation in patients undergoing CABG with low LVEF.

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