A Comparative Study of Effect of Propofol, Etomidate and Propofol Plus Etomidate Induction on Hemodynamic Response to Laryngoscopy and Endotracheal Intubation

Introduction In general anesthesia, stress response during laryngoscopy and intubation leads to hemodynamic changes especially in patients with cardiac risk factors like hypertension and ischemic heart disease. Propofol is commonly used drug for induction of general anesthesia. Propofol can lead to bradycardia and hypotension. Etomidate is hypnotic agent with better cardio stability. Background& Objective The primary objective of this study is to compare the efficacy of 3 different anesthesia approach (Propofol, Etomidate and Propofol plus Etomidate) in maintaining hemodynamic stability during induction and following endotracheal intubation in elective surgery. Material and method After taking institutional approval and informed consent, 60 patients aged 15-60 years of either sex and ASA (American society of anaesthesia) class I or II were studied. Group I induced with Propofol (2.5 mg/kg), Group II with Etomidate (0.3 mg/kg) and Group III with Propofol (1 mg/kg) plus Etomidate (0.2 mg/kg) intravenously. Heart rate (HR), systolic blood pressure, Diastolic blood pressure, Mean arterial blood pressure (MAP), Oxygen saturation were noted. Results HR and MAP decreased after induction in all groups and it was more in group I than group II and III. HR increased in all groups but more in group II after intubation. Significant increase in MAP was seen at 1 min after intubation in all groups but this increase was not sustained and returned to baseline in group II and III. Conclusion The combination of Etomidate plus Propofol was proved to be significantly better than either Propofol or Etomidate alone.