PHARMACOLOGY AND PHARMACY / RESEARCH PAPER
Comparison of the combination of propofol and etomidate versus propofol or etomidate alone for induction of general anesthesia: a double-blind, randomized controlled trial
More details
Hide details
1
The Second Affiliated Hospital of Anhui Medical University, China
2
Anesthesiology and Pain Medi-
cine, University of California Davis Health System, 4150 V St, Suite 1200,
Sacramento, CA 95817, United States
3
Anesthesiology and Pain Medicine, University of California Davis Health System, 4150 V St, Suite 1200,
Sacramento, CA 95817, United States
Submission date: 2020-08-23
Final revision date: 2021-06-04
Acceptance date: 2021-07-02
Online publication date: 2021-07-09
Corresponding author
Hong Liu
Anesthesiology and Pain Medi-
cine, University of California Davis Health System, 4150 V St, Suite 1200,
Sacramento, CA 95817, United States
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Hemodynamic fluctuation during the induction of general anesthesia is a common event and adversely affect patients’ outcomes. The aim of this study is to investigate the impacts of different anesthesia induction agents: propofol, etomidate, and propofol-etomidate combination on patient hemodynamics and processed electroencephalography (EEG).
Material and methods:
Seventy-five patients undergoing elective non-cardiac surgery were randomly assigned to three groups of anesthesia induction agents: the group P received 2 mg/kg propofol, the group E received 0.3 mg/kg etomidate, and the group PE received the combination of 1mg/kg propofol plus 0.15mg/kg etomidate. Hemodynamic variables and processed EEG were measured during induction.
Results:
Heart rate (HR) was significantly increased at intubation and 1 min after intubation compared with baseline in all three groups. Mean arterial pressure (MAP) decreased significantly after induction, at 5, and 10 min after intubation in group P (79.1±12.6, 77.0±14.2, 76.6±11.4 versus 93.2±9.9 mmHg; all P<0.001). MAP increased significantly at intubation and 1 min after intubation in group E (104.7±13.0, 103.8±12.8 versus 92.9±10.2; P<0.001, P=0.001 respectively). The incidence of myoclonus was lower in groups PE (4.0%) and P (4.0%) compared with that in group E (24.0%) (P=0.033). The incidence of pain at injection was higher in group P (28.0%) than that in groups PE and E (4.0% and 0.0%) (P=0.025).
Conclusions:
The combination of propofol and etomidate used during induction of anesthesia provided a more stable BP profile, less pain at site of injection, and decreased myoclonic movements compared with propofol or etomidate alone.