Haemodynamic Consequences of Etomidate Administration in Elective Cardiac Surgery

Morel, J.; Salard, M.; Castelain, C.; Bayon, M. C.; Lambert, P.; Vola, Marco; Auboyer, C.; Molliex, Serge

doi:10.1097/01.sa.0000415541.48113.97

Cited by 4 publications

(3 citation statements)

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“…According to the findings, there was a significant difference in SBP, DBP, and MAP between the two groups, with patients in group II showing more hypotension and patients in group I showing more stable blood pressure. Hiller et al, Reves JG et al, and Billard V et al previously demonstrated that inducing anaesthesia with propofol at a dose of 2-2.5 mg/kg body weight could lower blood pressure by up to 40%; this hypotension would occur in all patients, regardless of any underlying conditions [12,13,14]. In our study, we also discovered hypotension in 18.8 percent of the patients after propofol induction.…”

Section: Discussionsupporting

confidence: 75%

cross sectional observational study of cardiovascular response after propofol and etomidate anaesthesia induction

Kumbhare¹,

Tilkar²,

Churihar³

et al. 2022

ijhs

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Etomidate and propofol are two common anaesthetic drugs. Etomidate can be used in patients with little hemodynamic reserve, whereas Propofol can result in more hemodynamic instability, according to prior research. During the induction of anaesthesia with Etomidate or, as a comparison, Propofol in elective surgeries, the cardiovascular response was examined in this study. Patients who were admitted for elective surgeries and ranged in age from 18 to 60 were included in this cross-sectional observational study. The cardiovascular responses of 50 (47) patients were assessed prior to induction, after the induction of anaesthesia with drugs, and at 1, 3, 5, and 10 minutes following the laryngoscopy. These measurements included systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and O2 saturation (O2 sat). In terms of patient gender, age, and weight, there were no statistically significant differences between the two groups. At different times, changes in groups I and II's SBP, DBP, MAP, and HR were statistically significant. There were no discernible differences between groups I and II in terms of O2 saturation. Conclusion: Because Etomidate-treated patients have improved hemodynamic stability, it may be preferable to Propofol for general anaesthesia in the absence of contraindications.

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Section: Discussionsupporting

confidence: 75%

cross sectional observational study of cardiovascular response after propofol and etomidate anaesthesia induction

Kumbhare¹,

Tilkar²,

Churihar³

et al. 2022

ijhs

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“…However, no significant difference was found between the two groups. [20]. In our study, the blood cortisol levels were found to be suppressed in the etomidate-midazolam group compared to the ketamine-midazolam group in the postoperative ACTH stimulation tests on the first day after anesthesia induction and after surgery, whereas there was no difference between the groups in the ACTH stimulation test on the 4th day.…”

Section: Discussioncontrasting

confidence: 45%

Comparison of the hemodynamic effects of etomidate-midazolam and ketamine-midazolam combinations in anesthesia induction in coronary artery bypass surgery

FIRAT

Kömürcü²,

BAYRAKTAR³

et al. 2023

Turkish Journal of Clinics and Laboratory

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Aims: We aimed to compare the effects of anesthesia induction on hemodynamic parameters of ketamine-midazolam or etomidate-midazolam combinations and coronary artery bypass grafting surgery. Material and Methods: 40 adult patients undergoing CABG were randomly allocated into two groups for this prospective randomized double-blinded study. Ketamine group (n = 20) and Etomidate group (n = 20). Intraoperative and postoperative hemodynamic variables, adrenal gland functions and intensive care period were compared after anesthesia induction with etomidate and ketamine. Results: Perioperative hemodynamic parameters were not significantly different between the groups. Despite similar baseline measurements, cortisol levels were significantly higher 5 minutes after induction, during rewarming, and after ACTH stimulation test at postoperative day 1 in group ketamine than group etmidate. The groups were not significantly different in terms of duration of postoperative mechanical ventilation, frequency of postoperative delirium, and intensive care unit and hospital lengths of stay. Conclusion: Ketamine-midazolam combination is an acceptable alternative to etomidate-midazolam combination in terms of hemodynamic stability. Compared with the ketamine-midazolam combination, the etomidate-midazolam combination significantly decreased cortisol levels during the intraoperative and early postoperative periods

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“…New lipid emulsion preparation of etomidate associated with less pain and minimum venous irritation with provide better sedation and can be consider as induction agents of choice in respiratory disease patient because it has minimum histamine release and no respiratory depression and also it may be induction agent of choice in cardiac and neuro anaesthesia because minimum effect on sympathetic nervous system and baroreceptor reflex regulatory system, increased coronary perfusion. [2][3][4][5] But the incidence of myoclonus was persist with new preparation also.…”

Section: Introductionmentioning

confidence: 99%

A comparison of propofol and etomidate as anaesthetic agents for elective non-cardiac surgery

et al. 2018

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Background: To compare propofol and etomidate as anaesthetic agents for elective non-cardiac surgery with respect to stability of haemodynamic parameters, systemic side effects and quality of induction.Methods: Randomised, blinded study of 100 patients posted for elective non-cardia surgery under general anaesthesia, divided in to two group. In group P(n=50) induction was achieved with injection Propofol 1mg/kg, whereas in group E(n=50), it was achieved with injection etomidate 0.3mg/kg after premedication with injection midazolam 0.04mg/kg and fentanyl 2µg/kg in both the group. Hemodynamic parameters like, heart rate, systolic BP, diastolic BP, Mean BP and induction time in seconds, pain on injection, myoclonus, post-operative nausea, vomiting were recorded at different time intervals (base line, at induction, immediately after intubation and 1,3,5 and 15 min after intubation).Results: There was no statistically difference was found in demographic profile and baseline hemodynamic parameters but significant different was found in intraoperative mean HR, SBP, DBP, MBP at various time intervals, and our result was more in favour of E group as compare to P, in which above recorded vital parameters were decreased more than E and induction time was also faster in E as compare to P. Pain on injection and post-operative nausea, vomiting was more in group P as compare to E, however the myoclonus movements was more in E group as compare to P but statistically not significant.Conclusions: Etomidate is a better intravenous induction agent of anaesthesia than Propofol in hemodynamically unstable patient also as it has faster onset of action with less pain and post-operative nausea, vomiting with good hemodynamic stability.

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Haemodynamic Consequences of Etomidate Administration in Elective Cardiac Surgery

Cited by 4 publications

References 0 publications

cross sectional observational study of cardiovascular response after propofol and etomidate anaesthesia induction

cross sectional observational study of cardiovascular response after propofol and etomidate anaesthesia induction

Comparison of the hemodynamic effects of etomidate-midazolam and ketamine-midazolam combinations in anesthesia induction in coronary artery bypass surgery

A comparison of propofol and etomidate as anaesthetic agents for elective non-cardiac surgery

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