Key result
Etomidate for anesthesia induction caused a lower stress response but higher rates of postoperative nausea and vomiting compared to propofol, while smoking increased stress response and decreased PONV.
Why the study?
Does etomidate compared to propofol affect surgery-induced endocrine response and PONV in smokers and nonsmokers?
RCT (n=80)
randomly divided
Does etomidate compared to propofol affect surgery-induced endocrine response and PONV in smokers and nonsmokers?
Etomidate for anesthesia induction blunts the stress response (lower cortisol) but increases postoperative nausea and vomiting compared to propofol, with smoking modifying these effects.
Etomidate induction warrants PONV prophylaxis consideration despite blunted stress; extends RCT evidence on smoking's modifying effects.
To observe differences in the effects of etomidate, used for anesthesia induction, on surgery-induced endocrine response and postoperative nausea and vomiting (PONV) among nonsmokers and smokers. Materials and methods: Eighty adult patients with ASA I-II risk status were randomly divided into 2 groups: smokers (Group I, n = 40) and nonsmokers (Group II, n = 40). Patients were then further divided into subgroups according to the drug used for anesthesia induction, either propofol (Group IP and Group IIP) or etomidate (Group IE and Group IIE). Blood cortisol, insulin, glucose, and white blood cell (WBC) levels were measured and PONV scores were recorded. Results: Blood cortisol values were significantly lower in Group IE and Group IIE compared to Group IP and Group IIP during the 1st and 2nd hours after induction. By the 8th hour, blood insulin levels had increased significantly compared to the baseline values in Groups IE, IP, and IIP. Blood glucose levels were significantly higher in Group IIE compared to both Group IP and Group IIP. There was no significant difference between the WBC levels of the different groups. PONV scores were significantly higher in Group IIE compared to the other groups. Conclusion: We determined that the use of etomidate causes a lower stress response and more PONV compared to propofol, while smoking increases the stress response and decreases PONV.
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Sümer et al. (2012) conducted an RCT in Surgery requiring anesthesia (n=80). Etomidate vs. Propofol was evaluated on Blood cortisol, insulin, glucose, WBC levels, and PONV scores. Etomidate for anesthesia induction caused a lower stress response but higher rates of postoperative nausea and vomiting compared to propofol, while smoking increased stress response and decreased PONV.
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