Comparative Evaluation of Haemodynamic Response during Induction of General Anaesthesia and Incidence of Myoclonus with Etomidate and Propofol: A Randomised Controlled Trial
UC13-UC16
Correspondence
Dr. Balwinder Kaur,
House No. 97, The Colony Kheri Road, Patiala-147001, Punjab, India.
E-mail: balwinder.rekhi@yahoo.com
Introduction: An ideal induction agent for general anaesthesia should maintain haemodynamic stability, have minimal respiratory side effects, has rapid clearance and minimal drug interaction. Sudden hypotension has deleterious effects on maintaining circulation to vital organs.
Aim: To compare the haemodynamic response during induction in general anaesthesia and to evaluate the incidence of myoclonus with etomidate and propofol in adult patients posted for elective surgery.
Materials and Methods: A total of 100 adult patients of ASA Grade I and II between 18-60 years of age were randomised into two groups of 50 each receiving propofol {Group P 2 mg/kg Intravenous (i.v)} or etomidate (Group E 0.3 mg/kg i.v) as induction agent. The haemodynamic parameters including Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), SpO2 and EtCO2 were measured as baseline parameters before induction, immediately after induction, at intubation and then every 1 minute till 10 minutes and every 2 minutes till 20 minutes after intubation. Any myoclonus during induction was noted. Statistical analysis was done using EpiInfo software (7.1.0.6 version) and Microsoft Excel 2010.
Results: The demographic variables were comparable in both the groups. Statistical evaluation showed that the decrease in SBP, DBP and MAP was statistically significant (p-value<0.05) in Group P. The incidence of myoclonus was significantly high with etomidate. There was no significant difference with regards to HR, SpO2 and EtCO2.
Conclusion: Etomidate is a better agent for induction than propofol in view of haemodynamic stability but has high incidence of myoclonus.