The Variation in Plasma Cortisol Levels in Response to Anaesthetic Induction with Etomidate and Ketamine in Paediatric Patients Undergoing Patent Ductus Arteriosus Ligation

Abstract

Background:To compare the effect of anaesthetic induction with single dose etomidate versus ketamine on serum cortisol levels in paediatric patients posted for patent ductus arteriosus (PDA ) ligation surgery. Methods: A total of 60 paediatric patients in the age group of 2 to 8 yrs posted for PDA correction in the department of cardiothoracic surgery in a tertiary care centre, was selected for prospective randomized control study trial and allocated randomly into 2 groups-group E and K. Anaesthetic induction was done using single dose etomidate (group E) and ketamine (group K) and serum cortisol levels were compared in paediatric patients posted for PDA ligation surgery.Statistical analysis done using SPSS 20 software. Baseline continuous variables were compared using student 't' test for independent samples. The primary outcome (serum cortisol ) was compared using Wilcoxon Signed Ranks Test and student 't' test. The value less than 0.05 was considered significant. Results: The serum cortisol in group E was found to be significantly low 4 hour postoperatively compared to group K. However, serum cortisol increased 24 hour postoperatively in both groups and the increase was not found to be significant between the groups. Conclusion: Etomidate can be used for induction in paediatric cardiac surgery in patients without serious cortisol suppression lasting more than twenty four hours.