Comparison of haemodynamic response to laryngoscopy and endotracheal intubation following induction of general anaesthesia with propofol or etomidate

Abstract

Aims and Objectives: Propofol and etomidate are most frequently used intravenous induction agents, with very similar onset of action and duration of action, few advantages over each other and few unwanted effects. Recent studies and reintroduction of etomidate has paved way for its routine use in haemodynamically unstable patients. Materials and Methods: One hundred patients belonging to American Society of Anaesthesiologists (ASA) class I and II, aged between 18 to 60 years scheduled to undergo elective surgical procedure under general anaesthesia were selected. All the patients received tablet diazepam 0.2 mg/kg as premedication and fentanyl 2 mcg/kg body weight before induction. Patients were be randomly allocated to group P ((n = 50), who received propofol 2 mg/kg or group E (n = 50) who received, Etomidate 0.3 mg/kg as induction agent for general anaesthesia. Endotracheal intubation was facilitated by vecuronium 0.1mg/kg body weight. Heart rate (HR), Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were recorded at basal, after fentanyl, 1, 3, 5 and 10 min following induction. Results: There was no significant change in the heart rate at and after the induction, intubation in either group P or group E. There was significant decrease in SBP, DBP and MAP in group P following induction, whereas there was less decrease in Group E. There was increase in the SBP, DBP and MAP after intubation in both the groups, but in group P it did not increase above the basal and remained below the basal levels at 5 and 10 minutes following intubation. Conclusion: Etomidate provides stable haemodynamics at induction of general anaesthesia. But it does not attenuate the haemodynamic response to laryngoscopy and intubation. Propofol causes significant hypotension at induction and attenuates the pressor response to laryngoscopy and intubation.