Comparison of the Haemodynamic Response to Laryngoscopy and Endotracheal Intubation with Etomidate versus PropofolKetamine and Thiopentone-Ketamine in Lumber Spine associated Surgery: A Randomized Interventional Study

Background: Laryngoscopy and endotracheal intubation is commonly used for securing airway during odynamic disturbances. We aimed to determine the difference in haemodynamic variables during laryngoscopy and endotracheal intubation with Etomidate versus Propofol-ketamine and thiopentone-ketamine as induction agent in elective lumber spine associated surgery. Material and Methods: It was a Prospective randomized comparative interventional study on total 111 patients, aged 25-60 years of either sex with ASA physical status I and II who were randomly allocated into three groups (37in each group). Group A: Received inj. Etomidate 0.3 mg/kg IV, Group B received inj. Propofol 1.5 mg/kg IV + inj. Ketamine 0.5 mg/kg IV,Group C received inj. Thiopentone 3 mg/kg + inj. Ketamine 0.5 mg/kg IV; at induction of anaesthaesia.Haemodynamic parameters (SBP, DBP, MAP, and HR) were noted at baseline, after induction, justbefore intubation, and 1, 3, 5, 10 and 15 min after intubation. Side effects like myoclonus, post-operativenausea and vomiting (PONV) and hallucinations were also noted. Statistical analysis was performedusing ANOVA test and chi-square test (P significant). Results: Hemodynamic parameters were increased in all groups after intubation and was minimum in Group B compared to Group A and C at one min post intubation. Myoclonus and PONV were observed more in Group A than Group B and C (statistically nonsignificant in all three groups). Conclusion: Propofol-ketamine combination is a safe and effective induction agent with better hemodynamic stability as compared to Etomidate and thiopental-ketamine in general anaesthesia