Effect of Etomidate Versus Combination of Propofol-Ketamine and Thiopental-Ketamine on Hemodynamic Response to Laryngoscopy and Intubation: A Randomized Double Blind Clinical Trial
| Author | Afshin Gholipour Baradari | en |
| Author | Abolfazl Firouzian | en |
| Author | Alieh Zamani Kiasari | en |
| Author | Mohsen Aarabi | en |
| Author | Seyed Abdollah Emadi | en |
| Author | Ali Davanlou | en |
| Author | Nima Motamed | en |
| Author | Ensieh Yousefi Abdolmaleki | en |
| Issued Date | 2016-02-01 | en |
| Abstract | Background: Laryngoscopy and intubation frequently used for airway management during general anesthesia, is frequently associated with undesirable hemodynamic disturbances. Objectives: The aim of this study was to compare the effects of etomidate, combination of propofol-ketamine and thiopental-ketamine as induction agents on hemodynamic response to laryngoscopy and intubation. Patients and Methods: In a double blind, randomized clinical trial a total of 120 adult patients of both sexes, aged 18 - 45 years, scheduled for elective surgery under general anesthesia were randomly assigned into three equally sized groups. Patients in group A received etomidate (0.3 mg/kg) plus normal saline as placebo. Patients in group B and C received propofol (1.5 mg/kg) plus ketamine (0.5 mg/kg) and thiopental sodium (3 mg/kg) plus ketamine (0.5 mg/kg), respectively for anesthesia induction. Before laryngoscopy and tracheal intubation, immediately after, and also one and three minutes after the procedures, hemodynamic values (SBP, DBP, MAP and HR) were measured. Results: A repeated measurement ANOVA showed significant changes in mean SBP and DBP between the time points (P < 0.05). In addition, the main effect of MAP and HR were statistically significant during the course of study (P < 0.05). Furthermore, after induction of anesthesia, the three study groups had significantly different SBP, DBP and MAP changes overtime (P < 0.05). However, HR changes over time were not statistically significant (P > 0.05). Combination of propofol-ketamine had superior hemodynamic stability compared to other induction agents. Conclusions: Combination of propofol-ketamine may be recommended as an effective and safe induction agent for attenuating hemodynamic responses to laryngoscopy and intubation with better hemodynamic stability. Although, further well-designed randomized clinical trials to confirm the safety and efficacy of this combination, especially in critically ill patients or patients with cardiovascular disease, are warranted. | en |
| DOI | https://doi.org/10.5812/aapm.30071 | en |
| Keyword | Etomidate | en |
| Keyword | Propofol | en |
| Keyword | Ketamine | en |
| Keyword | Thiopental | en |
| Keyword | Hemodynamics | en |
| Keyword | Laryngoscopy | en |
| Publisher | Brieflands | en |
| Title | Effect of Etomidate Versus Combination of Propofol-Ketamine and Thiopental-Ketamine on Hemodynamic Response to Laryngoscopy and Intubation: A Randomized Double Blind Clinical Trial | en |
| Type | Research Article | en |
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