Induction with propofol plus etomidate provided better hemodynamic stability after intubation than either drug alone, with less heart rate decrease after induction compared to propofol (p<0.000).
RCT (n=90)
Randomized
Does the combination of propofol and etomidate improve hemodynamic stability compared to propofol or etomidate alone during endotracheal intubation in patients undergoing elective surgery?
A combination of propofol and etomidate provides superior hemodynamic stability during endotracheal intubation compared to either induction agent alone.
p-value: p=<0.000
Objective: The primary objective of this study was to compare the efficacy of 3 different anesthesia induction approach (Inj. Propofol, Inj. Etomidate and Inj. propofol plus Inj Etomidate) in maintaining hemodynamic stability during induction and following endotracheal intubation in elective surgery. Material and method: Ethical committee clearance taken, 90 patients aged 15 to 60 years of either sex and ASA physical status I or II scheduled for elective surgery under general anesthesia were taken for study. Written and informed consent was taken. The patients were randomly placed into three groups. Group I induced with Inj. Propofol (2.5 mg/kg) intravenous, Group II with Inj. Etomidate (0.3 mg/kg) intravenous and Group III with Inj. Propofol (1 mg/kg) plus Inj. Etomidate (0.2 mg/kg) intravenous. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and oxygen saturation (SPO2) were noted at different time interval. Results: Heart rate in all study groups decreases after induction and it was more in group I compared to group II and III (p<0.000) and after intubation HR increases in all three groups but this increase is greater in group II than other two groups. MAP among all three groups decreases after induction and it was more in group I than group II and III. Significant increase in MAP was seen at 1 min after intubation in all three groups but this increase was not sustained and returned to baseline in group II and III. Conclusion: The combination of etomidate plus propofol has better hemodynamic stability than etomidate alone at 1 min after intubation, though etomidate was equally stable at other points of time. The combination proved to be significantly better than either propofol or etomidate alone.
Meena et al. (2016) conducted an RCT in Elective surgery under general anesthesia (n=90). Propofol plus Etomidate vs. Propofol 2.5 mg/kg IV or Etomidate 0.3 mg/kg IV was evaluated on Hemodynamic stability (HR, SBP, DBP, MAP, SPO2) during induction and following endotracheal intubation (p=<0.000). Induction with propofol plus etomidate provided better hemodynamic stability after intubation than either drug alone, with less heart rate decrease after induction compared to propofol (p<0.000).