Comparison of etomidate and propofol as an induction agent to study hemodynamic effects and serum cortisol level following endotracheal intubation in hypertensive patients

Authors

  • Kinjal M. Solanki Department of Anesthesia, Gujarat Cancer & Research Institute, B. J. Medical Collage, Ahmedabad, Gujarat, India
  • Kinna G. Shah Department of Anesthesia, Dr. M. K. Shah Medical College, Chandkheda, Ahmedabad, Gujarat, India
  • Dipesh P. Shah Department of Anesthesia, S. V. P Hospital, N. H. L. Medical Collage, Ahmedabad, Gujarat, India
  • Jayshreeben M. Thakkar Department of Anesthesia, Gujarat Cancer & Research Institute, B. J. Medical Collage, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20233897

Keywords:

Intubation, Etomidate, Propofol, Myoclonus, Serum cortisol, Hemodynamic stability

Abstract

Background: The present study aimed to compare hemodynamic parameters (heart rate, blood pressure) and adverse effects (injection pain, myoclonus, postoperative nausea/vomiting) between Etomidate and propofol groups.

Methods: Patients were divided into two groups: Etomidate Group E and a Propofol Group P. All hemodynamic data were measured during induction, intubation, and post-intubation up to 15 min. Intravenous cortisol levels were measured at baseline, just after induction and at 24 hours after induction.

Results: At 3 min and 5 min SBP was decreased by 22.04% and 18.39% in Group P. At 3 min there was fall in DBP by 20.13% in group P whereas there was an increase in group E by 0.13% which is statistically significant (p<0.001). At 1 min, 3 min and 5 min after intubation, fall in the MAP by 26.07%, 21.08% and 18.60% in group P and 0.77%, 0.42% and 1.30% in group E (p value <0.001). Serum cortisol level immediate after surgery was decrease (54%) in Group E (p value <0.001). In Group P, 40% of the patients and in group E 16.66 % of the patients complained of pain on injection (p value 0.046).

Conclusions: The cortisol suppression by Etomidate may be beneficial for intubation stress response. Etomidate is better for its hemodynamic stability over propofol.

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Published

2023-12-26

How to Cite

Solanki, K. M., Shah, K. G., Shah, D. P., & Thakkar, J. M. (2023). Comparison of etomidate and propofol as an induction agent to study hemodynamic effects and serum cortisol level following endotracheal intubation in hypertensive patients. International Journal of Basic & Clinical Pharmacology, 13(1), 85–90. https://doi.org/10.18203/2319-2003.ijbcp20233897

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Original Research Articles