Key result
Etomidate-based anesthesia significantly reduced the incidence of hypotension (10.0% vs 42.5%) and other cardiovascular events compared to propofol in patients with coronary heart disease.
Why the study?
General anesthesia carries a heightened risk of perioperative cardiac complications and death in patients with CHD, making the choice of anesthetic strategy during major noncardiac surgery an important issue.
Does etomidate-based anesthesia reduce cardiovascular events and improve hemodynamic stability compared to propofol-based anesthesia in patients with stable coronary heart disease undergoing major noncardiac surgery?
Population
Patients (ASA grade II/III) with stable CHD (NYHA class I/II) undergoing major noncardiac surgery
Comparison
Etomidate/remifentanil-based vs propofol/remifentanil-based general anesthesia
Design
Blinded randomized clinical trial
Follow-up
24 h
Authors
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Supports etomidate over propofol to minimize hypotension in stable CHD noncardiac surgery; extends RCT evidence on induction agent selection.
RCT (n=80)
Triple-blind (patients, data collectors, and data analyzers)
Computer-generated random number table and sequentially numbered, opaque, sealed envelopes
No
Does etomidate-based anesthesia reduce cardiovascular events and improve hemodynamic stability compared to propofol-based anesthesia in patients with stable coronary heart disease undergoing major noncardiac surgery?
Absolute Event Rate: 10% vs 42.5%
p-value: p=0.027
In patients with stable coronary heart disease undergoing major noncardiac surgery, etomidate-based anesthesia provides better hemodynamic stability and fewer intraoperative cardiovascular events than propofol-based anesthesia.
Dai et al. (2021) conducted an RCT in Coronary heart disease (CHD) undergoing major noncardiac surgery (n=80). Etomidate vs. Propofol (2.0 mg/kg induction, 1.5-3.0 μg/mL target-controlled infusion maintenance) was evaluated on Hypotension during anesthesia (one of the primary cardiovascular events) (p=0.027). Etomidate-based anesthesia significantly reduced the incidence of hypotension (10.0% vs 42.5%) and other cardiovascular events compared to propofol in patients with coronary heart disease.
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