General anaesthesia with propofol versus etomidate and cognitive dysfunction in the immediate postoperative period: a randomized double-blind study

Malvika Patil; Naresh Tirpude

doi:10.18203/2319-2003.ijbcp20263783

Authors

Malvika Patil Department of Anaesthesiology, GMC Nagpur, Maharashtra, India
Naresh Tirpude Department of Anaesthesiology, GMC Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20263783

Keywords:

Propofol, Etomidate, Postoperative cognitive dysfunction, General anaesthesia, Haemodynamics, Randomized controlled trial

Abstract

Background: Propofol and etomidate are commonly used intravenous induction agents for general anaesthesia (GA), but comparative data on postoperative cognitive dysfunction (POCD) alongside haemodynamic and adverse-effect profiles are limited. This study compared propofol and etomidate with respect to POCD, haemodynamic stability, and adverse effects.

Methods: In this prospective, randomized, double-blind, parallel-group trial, 80 ASA I-II patients aged 18-40 years undergoing short elective surgery (dilation and curettage, or fracture reduction/fixation) under GA were randomized 1:1 to propofol 1 mg/kg (Group P, n=40) or etomidate 0.3 mg/kg (Group E, n=40) for induction. Cognitive function was assessed preoperatively and at 30, 60 and 120 minutes postoperatively using the Tirpude GMC-OMC score. Vitals were recorded intraoperatively (0-20 min) and postoperatively (0-60 min), and adverse effects were noted. Data were analysed using SPSS, with between-group differences and 95% confidence intervals reported; P<0.05 was considered significant.

Results: All 80 randomized patients were analysed. Baseline characteristics were comparable between groups. Tirpude GMC-OMC scores did not differ significantly between groups at any time point (p>0.05). Intraoperative vitals were significantly more stable in Group E than Group P at most time points (p<0.05). Hypotension was significantly more frequent in Group P (p=0.01); nausea and vomiting were more frequent, though not significantly, in Group E.

Conclusions: Propofol and etomidate produced comparable, clinically insignificant postoperative cognitive change in young, healthy patients undergoing short elective surgery. Etomidate offered superior intraoperative haemodynamic stability and less hypotension, while propofol was associated with less postoperative nausea and vomiting.

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